Christopher G Yheulon, MD, Priya Rajdev, MD, S. Scott Davis, MD. Emory University
INTRODUCTION: Evidence has demonstrated that biosynthetic glue for laparoscopic inguinal hernia repair results in decreased pain. However, the two glue sub-types (biologic – fibrin based; synthetic – cyanoacrylate based) have never been compared. This study aims to assess the outcomes of those subtypes.
METHOD AND PROCEDURES: A systematic review of the MEDLINE database was undertaken. Randomized trials assessing the outcomes of laparoscopic inguinal hernia repair with penetrating and glue fixation methods were considered for inclusion and data analysis. Thirteen trials involving 1633 patients were identified with eight trials utilizing fibrin and five trials utilizing cyanoacrylate.
RESULTS: There were no differences in recurrence or wound infection between the glue subtypes when compared individually to penetrating fixation alone or indirectly to each other. There was a significant reduction in urinary retention with fibrin glue when compared to penetrating fixation (OR 0.31, 95% C.I. 0.12-0.81). No studies utilizing cyanoacrylate analyzed urinary retention as an outcome. There were non-significant trends in reduction of hematoma and seroma for both glue subtypes when compared to penetrating fixation (OR 0.71, 95% Confidence Interval 0.50-1.01).
CONCLUSIONS: Glue fixation in laparoscopic inguinal hernia repair reduces the incidence of urinary retention and may reduce the rate of hematoma or seroma formation. As there are no differences in outcomes when comparing fibrin or cyanoacrylate glue, surgeons should choose the glue that is available at the lowest cost at their respective institution.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86450
Program Number: P495
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster