Randomized clinical trial of mesh fixation with glue or sutures for Lichtenstein hernia repair.

BackgroundPain is the most likely reason for delay in resuming normal activities after groin hernia repair. The primary aim of this study was to determine whether the use of glue to fix the mesh instead of sutures reduced acute postoperative pain after inguinal hernia repair. Secondary objectives were to compare postoperative complications, chronic pain and early recurrence rates during 1-year follow-up. MethodsSome 370 patients who underwent Lichtenstein hernia repair were randomized to receive either glue (Histoacryl (R)) or non-absorbable polypropylene sutures for fixation of lightweight polypropylene mesh. Postoperative complications, pain and recurrence were evaluated by an independent blinded observer. ResultsPostoperative pain at 8h, 24h, 7days and 30days was less when glue was used instead of sutures for all measures (P<0001). The operation was significantly quicker using glue (mean(s.d.) 353(87)min versus 399(111)min for sutures; P<0001). There were no significant differences between the groups in terms of postoperative complications, chronic pain and early recurrence at 1-year follow-up. ConclusionAtraumatic mesh fixation with glue was quicker and resulted in less acute postoperative pain than sutures for Lichtenstein hernia repair. Registration number: NCT02632097 (). Less acute pain