Mesh Fixation Methods in Laparoscopic Hernia Repair: Glue vs. Sutures vs. Tacks

Summary

This study is a clinical trial that aims to compare three different methods for securing a surgical mesh during a specific type of groin (inguinal) hernia repair surgery. The surgery is performed using a minimally invasive, keyhole technique called TAPP.

The main questions this study aims to answer are:

Which mesh fixation method-surgical glue, stitches (sutures), or small metal coils (tacks)-results in less pain for patients after surgery?

Which method leads to a better quality of life and less feeling of the mesh inside the body after recovery?

Is there a difference in how long the surgery takes with each method?

To answer these questions, researchers will compare the three methods to see which one works best for patient comfort and recovery.

Adults aged 21-60 years with a new inguinal hernia who are having laparoscopic TAPP surgery can participate.

Participants will be randomly assigned to one of three groups:

Group 1: Their mesh will be secured using surgical glue.

Group 2: Their mesh will be secured using stitches (sutures).

Group 3: Their mesh will be secured using small metal coils (tacks).

All other parts of the surgery and care after surgery will be the same.

Participants will:

Have the laparoscopic TAPP hernia repair surgery.

Report their pain levels after surgery using a simple scale.

Answer questions about their comfort and quality of life during follow-up visits at 1, 3, and 6 months after surgery.

Conditions

• Inguinal Hernia

Interventions

DEVICE

Cyanoacrylate Surgical Adhesive Fixation

Fixation of the polypropylene mesh using a cyanoacrylate-based surgical adhesive (Glubran-2®). The adhesive is applied in small drops at the mesh corners using a specific applicator device (GlueTack) to secure the mesh to the abdominal wall without mechanical penetration.

PROCEDURE

Suture Mesh Fixation

Fixation of the polypropylene mesh using two non-absorbable polypropylene sutures. The sutures are placed laparoscopically at the medial and lateral ends of the mesh to mechanically secure it to the abdominal wall tissues (e.g., Cooper's ligament, transversalis fascia).

DEVICE

Helical Titanium Tack Fixation

Fixation of the polypropylene mesh using multiple helical titanium tacks ( ProTack®). The tacks are fired laparoscopically around the periphery of the mesh, penetrating the abdominal wall to mechanically secure the mesh in place, while avoiding anatomical danger zones.

PROCEDURE

Laparoscopic Transabdominal Preperitoneal (TAPP) Inguinal Hernia Repair with Polypropylene Mesh Fixation. .

All participants in this study will undergo Laparoscopic Transabdominal Preperitoneal (TAPP) Repair of Inguinal Hernia, which is the standard surgical procedure. This minimally invasive technique involves: Creation of Pneumoperitoneum: The abdominal cavity is inflated with carbon dioxide gas. Port Placement: Three small incisions are made for camera and instrument ports. Peritoneal Incision: The peritoneum (inner abdominal lining) is cut to access the preperitoneal space in the groin. Hernia Reduction: The hernia sac and contents are pushed back into the abdominal cavity. Mesh Placement: A synthetic polypropylene mesh is positioned to cover the entire myopectineal orifice (the weak area where hernias occur). Mesh Fixation: The mesh is secured using one of three study methods (glue, sutures, or tacks) according to the assigned intervention arm. Peritoneal Closure: The initial peritoneal incision is closed over the mesh to isolate it from the abdominal organs.

Sponsors & Collaborators

• Cairo University

  lead OTHER

Principal Investigators

• Ahmed Eid Aziz · Cairo University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

21 Years

Max Age

60 Years

Sex

MALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-09-26

Primary Completion

2025-03-05

Completion

2025-10-01

Countries

• Egypt

Study Locations