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    • Polypropylene Suture Fixation versus Fibrin Glue in Lichtenstein Inguinal Hernia Repair: A Prospective Randomized Study

    Ahmed Shoka, MD, MRCS, Fady Makram, MD, FACS, Mohamed Matar, MD, FACS.
    Department of General Surgery, Ain Shams University, Cairo, Egypt.

    Background: In inguinal hernia repair, minimizing the intraoperative and postoperative complications and early ambulation are the main goals, however, traditional methods of mesh fixation are associated with several problems including substantial risks of early postoperative and chronic pain. The aim of this study is to evaluate the advantages of fibrin glue over polypropylene suture in mesh fixation in Lichtenstein inguinal hernia repair. Patients and methods: Fifty-two male patients with inguinal hernia underwent Lichtenstein hernia repair in the Department of General Surgery at Ain Shams University hospitals in the period from June 2013 to July 2015. The patients were prospectively randomized into two groups group A (polypropylene suture group) and group B (fibrin glue group). In group A, polypropylene sutures were used for mesh fixation, and in group B fibrin glue was used for mesh fixation. Ilio-inguinal nerve was dissected and preserved in all cases. Results: The mean age of patients in group A was 43.5 years and that of group B patients was 41.2 years. There was a significant difference in the duration of surgery, with the mean duration in polypropylene suture group was more that of the fibrin glue group. The mean numeric rating pain scale of postoperative pain at 1, 6, 12, and 24 h was significantly higher in the suture group than in the fibrin glue group (p<0.001). The mean total dose of analgesia in ampoules of pethidine was significantly less in the fibrin glue group (0.80 ampoules) than that in the polypropylene suture group (2.25 ampoules) with p=0.002 while the incidence of chronic pain was higher in the polypropylene suture group than that in the fibrin glue group. Conclusion: this study demonstrates that the use of fibrin glue instead of polypropylene suture in Lichtenstein inguinal hernia repair can help in decreasing the operative time, postoperative pain, hospital stay, and the incidence of chronic groin pain. Key words: Fibrin glue, polypropylene, inguinal hernia, mesh fixation. 

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