N-Butyl-2-Cyanoacrylate Adhesive Versus Absorbable Tacks in Laparoscopic Groin Hernia Repair: A Multicenter...

Area of Science:

• Minimally Invasive Surgery
• Surgical Materials Science
• Hernia Repair Techniques

Background:

• Chronic pain post-laparoscopic groin hernia repair is linked to penetrating fixation methods.
• Lack of FDA-approved devices for nonpenetrating fixation in this surgical context.
• Need for safer fixation techniques in laparoscopic hernia surgery.

Purpose of the Study:

• To evaluate the safety and efficacy of n-butyl-2-cyanoacrylate (NB2C) adhesive for nonpenetrating mesh and peritoneal fixation.
• To compare NB2C adhesive fixation with absorbable tacks in laparoscopic groin hernia repair.
• To assess pain reduction, recurrence rates, and adverse events associated with NB2C adhesive.

Main Methods:

• Randomized controlled trial involving 284 patients undergoing laparoscopic groin hernia repair (TAP or TEP).
• Patients were randomized to mesh/peritoneal fixation with NB2C adhesive or absorbable tacks.
• Primary outcome: pain improvement (Visual Analog Scale) at 6 months; secondary outcomes: recurrence, device success, quality of life, adverse events.

Main Results:

• NB2C adhesive demonstrated noninferiority to absorbable tacks in pain improvement at 6 months (VAS).
• No significant differences were observed in recurrence rates, device success, or quality of life between the two fixation methods.
• Rates of adverse and serious adverse events were comparable between the NB2C adhesive and absorbable tacks groups.

Conclusions:

• N-butyl-2-cyanoacrylate (NB2C) adhesive is a safe and effective option for mesh and peritoneal fixation in laparoscopic groin hernia repair.
• NB2C adhesive provides a viable alternative to absorbable tacks, offering similar clinical outcomes and safety profiles.
• The study supports the use of NB2C adhesive for nonpenetrating fixation, potentially reducing chronic pain associated with hernia repair.