Prospective Comparision in Closure of the Peritoneum in Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair (TAPP) with Cyanoacrylate Glue vs Barbed Sutures

Aims and Objectives:To compare the peritoneal closure technique using cyanoacrylate glue with a microdroplet device in laparoscopic transabdominal preperitoneal repair (TAPP) of inguinal hernia with the routinely used barbed suture peritoneal closure (V-Lock 3.0).Materials and Methods: From January to December 2023, 60 patients undergoing TAPP repair for uni-or bilateral inguinal hernia were randomized into one of two groups.One using as mesh fixation and peritoneal closure the cyanoacrylate glue (Glue-close group) and the other using mesh fixation with cyanoacrylate and peritoneal closure with V-lock 3.0 (Sut-close group), with a follow-up of 9 months.Operative time, peritoneal closure time, main surgical findings and main intra-and postoperative complications were analyzed prospectively.Results: 60 patients were included with no losses to follow-up.The mean operative time was 33 min (range 58.25) for the glue-close group and 41 (range 64.25) for the sut-close group, with no conversion (0%) for either group.The mean flap closure time was 1.20 min (SD 24 0.19) for the glue-close group and 3.26 min (SD 0.78) for the sut-close group, with statistically significant differences (p < 0.001).The intraoperative complication rate was 0 for the glue-close group and 0 for the sut-close group, with no significant difference.The median hospital stay was 0.8 days (range, 0-1) for both groups.The median duration of follow-up was 9 months and none had hernia recurrence.The postoperative VAS score at the first and second check-up at 1 month and 3 months was 2.83 (SD 1.341) and 0.60 (SD 0.621) in the sut-close group and 1.03 (0.984) and 0.24 (SD 0.435) in the glue-close group, with significant differences (p < 0.001 and p < 0.012). Conclusion:The data demonstrated by this study are that the glue can be used safely to close the peritoneum and that the method provides a small, statistically significant but not clinically relevant reduction in the time for peritoneal flap closure, as well as in postoperative pain after surgery in short and medium term.