The aim of this study was to demonstrate the efficacy and safety and report the results of
prosthesis fixation by means of
fibrin glue during laparoscopic treatment of inguinal and
femoral hernias. From September 2001 to December 2004 we employed
fibrin glue (
Tissucol, Baxter, Maurepas) as a means of fixation during a transabdominal preperitoneal procedure in 230 patients (225 M, 5 F) with an average age of 45 years (range: 20-75) presenting a total of 320
hernias: 140/230 (60.8%) were monolateral and 90 (39.2%) bilateral; 267/320
hernias (83.6%) were primary and 53 (16.4%) recurrent. We had no perioperative complications. After an average follow-up of 26 months (range: 1-40) the only postoperative complications we encountered were 6
seromas (1.8%) and 1
trocar-site haematoma (0.3%). None of the patients developed scrotal haematomas. None of the patients complained of immediate or subsequent paraesthesia or cruralgia. No recurrences have occurred to date. The mean
operative time was 30 minutes for monolateral
hernias (range: 15-45) and about 50 minutes for bilateral
hernias (range: 30-75). This was true of both primary and recurrent
hernias. Patients are usually discharged on day 1 postoperatively. In the absence of
pain, working activities are resumed after 5 days and sports can be practiced after 10 days. In our experience,
fibrin glue (
Tissucol) is the best way of fixing the mesh during a transabdominal preperitoneal procedure. It is better than mechanical devices because, though guaranteeing prosthetic stability, it is completely non-traumatic and presents none of the problems of
metal clips.