COMPARATIVE STUDY OF TECHNIQUE OF MESH FIXATION IN OPEN INGUINAL HERNIA REPAIR BETWEEN N-BUTYL CYANOACRYLATE GLUE AND SUTURE.

Introduction Inguinal hernia is the most frequently diagnosed hernia. It accounts for 75% of all abdominal wall hernias and has a lifetime incidence of 27% in males and 3% in women. Open inguinal hernia repair has long been the method of choice for most surgeons and is often recommended in contemporary literature as the optimal approach for primary unilateral inguinal hernia. Lichtenstein tension free mesh repair remains the standard criterion. It is known to be relatively simple and effective with minimal pain. Objective The aim of this study is to compare the efficacy of N-butyl cyanoacrylate glue with that of classical method of mesh fixation by suture in Lichtenstein tension free Inguinal Hernia repair in terms of chronic groin pain without increasing other complications. Methods A Prospective, Hospital based observational comparative study was planned, which includes 40 patients per group. All patients included were above 18 years of age. All the participants were divided into 2 groups mesh fixation with sutures and N-butyl cyanoacrylate glue. Total duration of the study was 3 months from the day of the surgery with 4 intervals of follow up at POD1, POD 7, Month 1 and Month 3. Results When comparing postoperative pain between the groups, it was observed that patients in the glue fixation group experienced significantly less pain than those in the suture group at various intervals: postoperative day 1 (POD1), postoperative day 2 (POD2), 1 month, and 3 months. Additionally, immediate pain was notably reduced in the glue fixation group. Furthermore, no reports of pain were recorded at 1 month and 3 months postoperatively. Moreover, the incidence of local complications was lower in the glue fixation group compared to the suture fixation group. Conclusion The use of N-butyl cyanoacrylate glue resulted in reduced immediate postoperative pain and quicker recovery times due to its less invasive nature and avoidance of tissue trauma associated with sutures. Additionally, the application of glue was found to be faster and technically easier, potentially reducing operation time with no recurrence. Conversely, traditional suture fixation, while reliable, was associated with higher postoperative discomfort and a slightly increased risk of complications such as chronic pain. [ABSTRACT FROM AUTHOR]