Cynoacrylate surgical glue as an alternative to suturing for mesh fixation in lichtenstein hernia repair

The Lichtenstein technique is a standard procedure for open tension-free inguinal hernia repair performed using meshes to strengthen the posterior wall of inguinal canal. Tension free repair using mesh in Lichtenstein inguinal hernia surgery has led to a substantial decrease in hernia recurrence. The prevalence of postoperative pain after open and laparoscopic procedures has been reported to be as high as 30%. Estimate is that 12% of patients feel themselves to be restricted in their daily activities because of pain. Conventionally, the mesh is secured by either sutures or staples. Despite the ‘‘tension-free’’ nature of these hernioplasties, sutures and staples may strangulate muscle fibers, compress regional nerves, or give rise to incapacitating pain or dysesthesia. Complications associated with sutured mesh fixation following open groin hernia repair have prompted surgeons to evaluate methods of atraumatic fixation, such as the use of human fibrin glue. Fibrin glue is a biodegradable adhesive combining human-derived fibrinogen and thrombin that replicates the last step of the ABSTRACT