Fibrin glue for mesh fixation in laparoscopic transabdominal preperitoneal (TAPP) hernia repair: indications, technique, and outcomes

Abstract

The authors' experience demonstrates that fibrin glue (Tissucol) is an effective method for mesh fixation during TAPP.

Evaluation of intraperitoneal placement of absorbable and nonabsorbable barrier coated mesh secured with fibrin sealant in a New Zealand white rabbit model

“…As evidenced by the multiple articles detailing the use of FS in laparoscopic TAPP and TEP repairs [8][9][10][11][12][13], FS is quickly gaining popularity as a sole method of mesh fixation. Some physicians are even referring to FS as the ''gold standard method for mesh fixation'' [10].…”

“…Some physicians are even referring to FS as the ''gold standard method for mesh fixation'' [10]. Arguably, adequate fixation for mesh in laparoscopic TAPP and TEP repairs does not equate with adequate fixation in LVHR.…”

“…An FS product, TISSEEL/TISSUCOL (Baxter Healthcare Corp, Deerfield, IL, USA), manufactured with a 500 IU/ml thrombin concentration, has been used as an alternative fixation method in multiple laparoscopic transabdominal preperitoneal (TAPP) and totally entraperitoneal (TEP) series [5,[8][9][10][11][12][13]. Another formulation of FS, ARTISS (Baxter Healthcare Corp), contains a lower concentration of thrombin and received Food and Drug Administration (FDA) approval in 2008 for the purpose of skin graft fixation to burn wound beds [14].…”

“…They are packaged as two separate components (human-derived fibrinogen and calcium chloride-activated thrombin), which are mixed at application and form polymerized fibrin chains [2]. The fibrinogen component gives the product its tensile strength [10], and the thrombin concentration affects the rate of fibrin polymerization.…”

Fibrin glue for intraperitoneal laparoscopic mesh fixation: a comparative study in a swine model

“…Fibrin glue causes a chemotactic attraction and stimulation of fibroblasts that result in enhanced tissue integration, achieving biologic soft fixation [28,29]. Prospective data also suggest that use of fibrin sealant significantly decreases pain and bleeding complications by avoiding the penetrating trauma and resultant neurovascular injury seen with sutures and tacks [12,15,16,20,27,30,31].…”