Stapling Versus Fibrin Glue for Mesh Fixation in Laparoscopic Inguinal Hernia Repair in Transabdominal Preperitoneal Technique

Abstract Background: Inguinal hernias are the most common hernias; they account for 90% of all spontaneous hernias. Moreover, inguinal hernia repair is the most frequently per-formed procedure in general surgery. Aim of Study: The aim of this study is to compare outcomes of mesh fixation using fibrin glue versus staple in laparoscopic transabdominalpreperitoneal (TAPP) repair of inguinal hernia. Patients and Methods: This study was a prospective randomized study. It included 40 adult patients of different age group presented with unilateral inguinal hernia, admitted and undergone laparoscopic inguinal hernia repair with mesh fixation, divided into 2 equal groups. All patients undergone (TAPP) approach done at Ahmed Maher teaching hospital over a period from 2021 to 2022, It included 40 patients complaining of inguinal hernia who were fit for surgery. Results: There was no statistical significant difference between two groups as regarding age, and also no statistical significant difference between two groups as regarding gender. Regarding the type of hernia presented in this study, we found that about 20% of patients had direct hernia and 80% patients had indirect hernia. Therefore, there was no statistical signif-icant difference between two groups as regarding type of hernia. Regarding the intra-operative complications, our results illustrated that there was no statistical significant difference between the two groups only one case in group II had intra-operative surgical emphysema and oozing of blood during dissection. Conclusion: Mesh fixation by fibrin glue is better than with staples as mesh fixation with glue causes less postoper-ative pain and less analgesia is needed. This study demonstrates that fibrin glue are well tolerated than tacks by patients and that the glues lead to the same good results during initial follow-up and in long term data. Large randomized prospective trial are required to demonstrate the real advantages of either fixation methods in presence of standardized technique and perfect knowledge of anatomy.