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Fibrin versus cyanoacrylate glue for fixation in laparoscopic inguinal hernia repair: a network meta-analysis and indirect comparison

  • Kelli TavaresEmail author
  • John Mayo
  • Kenneth Bogenberger
  • S. Scott DavisJr.
  • Christopher Yheulon



Evidence has demonstrated that biosynthetic glue for laparoscopic inguinal hernia repair results in decreased pain. However, the two glue sub-types (biologic—fibrin based; synthetic—cyanoacrylate based) have never been compared. This study aims to assess the outcomes of those subtypes.

Method and procedures

A systematic review of the MEDLINE database was undertaken. Randomized trials assessing the outcomes of laparoscopic inguinal hernia repair with penetrating and glue fixation methods were considered for inclusion and data analysis. Thirteen trials involving 1947 laparoscopic inguinal hernia repairs were identified with eight trials utilizing fibrin and five trials utilizing cyanoacrylate.


There were no differences in recurrence or wound infection between the glue subtypes when compared individually to penetrating fixation alone or indirectly to each other. There were non-significant trends in reduction of hematoma and seroma for both glue subtypes when compared to penetrating fixation (OR 0.73, 95% CI 0.39–1.40). There was a significant reduction in urinary retention with glue fixation (pooled results of both sub-types) when compared to penetrating fixation (OR 0.33, 95% CI 0.13–0.83).


Glue fixation in laparoscopic inguinal hernia repair reduces the incidence of urinary retention and may reduce the rate of hematoma or seroma formation. As there are no differences in outcomes when comparing fibrin or cyanoacrylate glue, surgeons should choose the glue that is available at the lowest cost at their respective institutions.


Fibrin glue Cyanoacrylate glue Laparoscopic inguinal hernia repair Fixation 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

Institutional review board approval was not required.

Human and animal rights

As this was a systematic review of the literature, no human rights, animal rights were involved.

Informed consent


Supplementary material

10029_2019_2072_MOESM1_ESM.xlsx (10 kb)
Supplementary file1 (XLSX 11 kb)


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgeryTripler Army Medical CenterHonoluluUSA
  2. 2.Department of SurgeryEmory University School of MedicineAtlantaUSA

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