Reduced Chronic Pain Following Laparoscopic Totally Extra-peritoneal Inguinal Hernia Repair Using Glue: A Randomized Clinical Trial

Purpose: Chronic pain following laparoscopic inguinal hernia repair occurs in up to 20% of the patients. We aim to compare glue and absorbable tackers on the rate of chronic pain after surgery in patients undergoing laparoscopic inguinal hernia repair. Methods Patients undergoing laparoscopic totally extraperitoneal inguinal hernia repair were enrolled in a single-blind randomized clinical trial and were randomized for mesh fixation with glue or absorbable tackers. Pain was assessed using a validated 4-point verbal-rank scale at 1 week, 1 month, 6 months and 1-year postoperatively. Chronic pain was defined as pain persisting beyond three months. Results Overall, 208 patients were analyzed. Chronic pain of any intensity was reported in 31.7% (66/208) after 6 months and in 13% (29/208) after12 months. No differences in postoperative pain were observed between the two forms of mesh fixation. Mesh fixation with glue resulted in less severe pain compared to fixation by tackers (logrank p = 0.025). Conclusions No differences in chronic pain rate were identified between tacker and glue fixation. Severe pain, however, was less common following glue fixation.