Pakpoom Tirawattanakul, Dr, Panot Yimcharoen, Dr, Poschong Suesat, Dr, Setthasiri Pantanakul, Dr, Jadsada Athigakunagorn, Dr, Petch Kasetsuwan, Dr. Bhumibol Adulyadej Hospital
Background: Mesh fixation with staples may be the cause of chronic inguinal pain. The aim of this study was to compare the post-operative pain between the use of ProTackTM and n-butyl cyanoacrylate Histoacryl® glue for mesh fixation in laparoscopic TEP inguinal hernia repair.
Methods: This was a prospective cohort study. Thirty-eight patients (35M,3F) with 22 bilateral (all males), 16 unilateral underwent surgery from May 2014 to April 2016. A total of 60 inguinal hernia repairs were included (30 by ProTackTM, 30 by Histoacryl®). The post-operative pain scale (VAS), feeling of inguinal discomfort, length of stay (LOS), operative time, instrument cost, overall cost, complication and recurrence rate [mean follow up 9 months (5-30)] were collected.
Results: On the 4th hour, the average post-operative pain score after using ProtackTM and Histoacryl® was 3.11±2.04 and 2.59±1.48, respectively. After three months, 5 of 30 repairs in ProtackTM group felt inguinal discomfort, while no inguinal discomfort in Histoacryl® group. The average LOS and operative time: 3.10±0.71 and 3.23±1.38 days; 84.67±23.94 and 91.67±24.82 minutes, respectively. The cost of ProtackTM in each patient was 102.86 USD while Histoacryl® was 28.57 USD. The overall cost was 1,117.16±72.56 USD and 1,165.91±173.27 USD. Two seromas were observed in ProtackTM group, and there were 2 recurrences after operation in Histoacryl® group.
Conclusions: The advantages of Histoacryl® are the decrease of late post-operative inguinal discomfort (p=0.006) and the expense of mesh fixation instrument. The complication and recurrent rate in 9 months were not different.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79153
Program Number: P608
Presentation Session: Poster (Non CME)
Presentation Type: Poster