***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction With an average incidence rate of 11 % , chronic pain is considered the most serious complication of inguinal hernioplasty after surgical site infection . One of the proposed solutions to this problem is to use tissue adhesive for mesh fixation , which helps prevent nerve and tissue damage . Aim The goal of this study was to compare mesh fixation with the use of sutures vs. adhesive in Lichtenstein 's inguinal hernia repair in a r and omized , double-blind one-center study . Material and methods The study group consisted of 41 males with primary inguinal hernia undergoing Lichtenstein 's repair ( 20 – adhesive ; 21 – suture ) and remaining in follow-up from July 2008 to November 2010 . R and omization took place during the operation . The follow-up was performed by one surgeon ( blinded ) according to a pre-agreed schedule ; the end-of- study unblinding was performed during the last follow-up visit , usually 16 months postoperatively . Results In 1 patient from the “ adhesive ” group , a recurrence was observed one year after the initial repair . The early postoperative pain was less intense in this group . In later postoperative periods the method of mesh fixation had no influence on the pain experienced by the patient . Other complications were not correlated with the method of mesh fixation . Conclusions In this r and omized , one-center double-blind clinical study of males with primary inguinal hernia it has been show during follow-up that the use of Glubran 2 cyanoacrylate adhesive for mesh implant fixation yields similar recurrence and chronic pain rates as the classical suture technique . In the early postoperative period , the pain reported by these patients was relatively weaker ; patients undergoing adhesive mesh fixation experienced a quicker return to daily household activities BACKGROUND We compared the effectiveness of n-butyl-2-cyanoacrylate ( NBCA ) and traditional suture for patch fixation in Lichtenstein tension-free herniorrhaphy for inguinal hernias . METHODS A total of 110 patients with primary unilateral inguinal hernia were assigned r and omly to either experimental or control groups . In the experimental group , NBCA adhesive was used during Lichtenstein herniorrhaphy ; traditional suture was used in the control group . We evaluated operation time , postoperative duration of stay , visual analogue scale ( VAS ) pain score , incidence of chronic pain and hematoma formation , and hernia recurrence . RESULTS There was no hernia recurrence or wound infection in either group . In the experimental group , 2 local hematomas occurred while no patients experienced chronic postoperative pain ; in the control group , 10 hematomas occurred , and 6 patients experienced chronic pain . There was no difference in postoperative duration of stay between the groups ( P > .05 ) , but the experimental group had a lesser operation time and postoperative VAS score ( P < .05 ) . CONCLUSION The use of NBCA medical adhesive in tension-free inguinal herniorrhaphy is effective and safe The Lichtenstein hernioplasty has become a popular method in inguinal hernia repair . This study compared two methods of mesh fixation and wound closure . Forty-six men with unilateral inguinal hernia were r and omized into two groups . In the control group polypropylene mesh was anchored with 3/0 Dexon sutures , fascia and skin were closed with sutures 3/0 Dexon and 3/0 Monosof . In the study group , the mesh was secured with butyl-2-cyanoacrylate adhesive and the fascia and skin were also glued with the adhesive .  The costs of material s , duration of the operation , amount of postoperative analgesic doses , pain score after the first and the 7th postoperative day and return to daily activity were recorded . No recurrences during the mean follow-up of 4.7 months were observed and the cosmetic effect was very good . In the study group with tissue adhesive the patients had significantly lower pain score after the first postoperative day and had a tendency to require less analgetic doses and to return earlier to their daily activity . Duration of the operation was similar in both groups . The cost of sutures and tissue adhesive used in both procedures was comparable . The use of tissue adhesive in mesh fixation and wound closure seems to be a promising technique in Lichtenstein hernia repair Introduction : This was a prospect i ve , r and omised study undertaken from January 2001 to July 2003 firstly to assess the possibility of using glues to fix meshes , secondly to verify whether or not this leads to a higher hernia recurrence rate , and thirdly to assess post-operative pain . Methods : This study covered a total of 55 patients with bilateral hernias who presented similar characteristics on both sides and on whom fixation of the mesh was undertaken differently , depending on the side . On the right side polypropylene sutures were used ( prolene 2/0 ) , while on the left , attachment was done using glue ( Tissucol ) . Results and conclusions : Results were similar in both inguinal regions , although there was less post-operative pain and less inflammatory reaction on the left side . There was no hernia recurrence in the follow-up at the end of 1 Purpose The aim of the present r and omised study was to find out whether usage of lightweight mesh in inguinal hernia repair , compared with heavyweight mesh , results in decreased incidence of chronic groin pain and foreign body feeling , as well as to evaluate the risk factors for chronic pain development and hernia recurrences . Methods The patients were r and omised into the heavyweight mesh ( HW ) group and lightweight mesh ( LW ) group . A tension-free mesh repair using the Lichtenstein technique was performed on all patients . Pain scores during different activities were measured on visual analogue scale . All patients underwent a clinical examination for any evidence of hernia recurrence . Results Of the patients , 17.2 % in the HW group and 29.3 % in the LW group reported that they experienced pain at 3-year follow-up ( P = 0.1323 ) . Pain was most often reported during physical activity . The median VAS score of all studied activities was 30.5 in the HW group and 30.0 in the LW group . There were more patients in the HW group than in the LW group who stated that they could feel the mesh in the groin ( 27.6 vs. 20.7 % , P = 0.3967 ) . Among all patients , 42.9 % who had severe pain preoperatively also reported pain during different activities and 19.6 % of the patients who did not have severe pain preoperatively reported pain during different activities ( P = 0.0481 ) . At 3-year follow-up , there was 1 hernia recurrence in the HW group and 1 hernia recurrence in the LW group . Conclusions Our study shows that compared with HW mesh , LW mesh has no advantage in reducing chronic groin pain and foreign body feeling at the operation site after inguinal hernioplasty at 3-year follow-up . Severe preoperative pain was correlated with the development of chronic pain . There was no difference between the two study groups in the recurrence rates A pre-trial was conducted to investigate the reliability of using the surgical adhesive , BioGlue ™ ( CryoLife ® , Inc. , Kennesaw , Georgia , USA ) for mesh fixation in Lichtenstein repair of inguinal hernia . From February to August 2008 , 60 patients with unilateral inguinal hernia underwent a Lichtenstein repair .  In 30 of the patients , BioGlue ™ was used for mesh fixation and in the other 30 cases a conventional suture was used . The patients were sorted into two groups ( BioGlue ™ -group and suture-group ) . No differences were noted in demographic characteristics . The main criteria for dropout were incarceration , relapse , operation , and /or scrotal hernia . Twenty-four hours postoperative , pain intensity was measured with a numeric analogous scale ( NAS ) that reached from 0 ( no pain ) to 10 ( heavy pain ) . The pain intensity in the BioGlue ™ -group was 2.4 points and 4.3 points in the suture-group . The cut-suture time was 30 minutes in the BioGlue ™ -group and 56 minutes in the suture-group . In the first nine months , no relapses , no mesh infections , nor serom-formations were reported ; however , one superficial wound infection did occur in the BioGlue ™ -group . Lichtenstein-repair using BioGlue ™ for mesh-fixation is a safe , new method without early recurrences and less pain-intensity in relation to suture-supported Lichtenstein repair OBJECTIVE Three different mesh fixation techniques were compared to find out how to perform a safe and cost-effective  open inguinal hernioplasty in day-case setting with the best outcomes with regard to chronic pain . SUMMARY BACKGROUND DATA Mesh fixation method may influence on the incidence of chronic pain  after Lichtenstein hernioplasty . METHODS Lichtenstein hernioplasty was performed under local anesthesia in 625 patients as day-case surgery in 8 Finnish hospitals . The patients were r and omized to receive either a cyanoacrylate glue ( Histoacryl , n = 216 ) , self-gripping mesh ( Parietex ProGrip , n = 202 ) , or conventional nonabsorbable sutures ( Prolene 2 - 0 , n = 207 ) for mesh fixation . The incidence of wound complications , pain , recurrences , and patients discomfort was recorded on days 1 , 7 , 30 , and 1 year after surgery . The primary endpoint was the sensation of pain measured by pain scores and the need of analgesics after 1 year of surgery . RESULTS The type and size of inguinal hernias  were similar in the 3 study groups . The duration of operation was 34 ± 13 , 32 ± 9 , and 38 ± 9 minutes in the glue , self-gripping , and suture groups , respectively ( P < 0.001 ) . There were no significant differences postoperatively in pain response or need for analgesics between the study groups . Two superficial infections ( 0.3 % ) , 31 wound seromas ( 5.0 % ) , and 4 recurrent hernias ( 0.6 % ) were recorded during a 1-year follow-up . Some 25 patients ( 4.2 % ) needed occasionally analgesics for chronic groin pain . A feeling of a foreign object and quality of life were similar in all study groups . CONCLUSIONS This r and omized trial failed to prove that mesh fixation without sutures causes less inguinodynia  than suture fixation in Lichtenstein hernioplasty . Mesh fixation without sutures is feasible without compromising postoperative outcome Background Complications associated with sutured mesh fixation following open groin hernia repair have prompted surgeons to evaluate methods of atraumatic fixation such as the use of human fibrin glue . Small trials with Tissucol/Tisseel fibrin glue ( Baxter Healthcare , Deerfield , IL , USA ) have shown promising results that warrant further investigation . Methods TIMELI ( Tissucol/Tisseel for MEsh fixation in LIchtenstein hernia repair ) is an international , controlled , r and omized , patient- and evaluator-blinded study that is comparing mesh fixation with Tissucol or sutures in patients with inguinal hernia . The primary endpoint evaluates the incidence of disabling complications ( chronic pain and /or numbness and /or groin discomfort ) at 12 months post-surgery . Results Patient enrolment started in February 2006 and ended on 19 April 2007 , with a total of 325 patients recruited . Initial results are expected in early 2008 . Conclusions TIMELI is a major international trial that will provide important information on the efficacy and safety of Tissucol , compared with sutures , for mesh fixation in patients undergoing Lichtenstein technique for primary inguinal hernia repair Background  Early post-operative pain after inguinal hernia repair delays management in ambulatory setting . The type of mesh used for repair appears to influence their incidence . Aims The aim of this r and omized , prospect i ve study using the alternation principle was to compare post-operative early pain and the quality of life of patients operated on for inguinal hernia depending on the type of mesh used and their impact on management in ambulatory setting . Patients and methods Fifty successive patients were included prospect ively .  Hernia repair was performed using the Lichtenstein procedure with two types of mesh , namely st and ard polypropylene 100 g/m2 ( Prolène ® ) or light polypropylene ( 55 g/m2 ) with a natural beta-d-glucan coating ( Glucamesh ® ) . The main assessment criterion was post-operative pain evaluated twice daily by the patient for 7 days , using the visual analogue scale ( VAS ) and their use of analgesics . The secondary assessment criteria were the rate of unscheduled admissions the evening of the intervention and the hospital length of stay and the quality of life evaluated by the SF12 question naire at pre-operative stage and on days 7 and 30 . Results The two groups were comparable . The operative duration s were identical ( 38.8 ± 10.2 vs 48 ± 15.4 min ) . On the evening of the intervention before discharge , the pain was less intense in the Glucamesh ® group ( mean VAS score 21.6 ± 2.4 vs 31.7 ± 6.2 , p = 0.02 ) . On day 4 , 20 % of patients from the Glucamesh ® group and none of the patients from the Prolène ® group had a VAS score of 0 ( p = 0.02 
    Output:
    
Based on the short-term results , glue may reduce postoperative chronic pain and not simultaneously increase the recurrence rate , compared with sutures for mesh fixation in Lichtenstein hernia repair .
Glue may therefore be a sensible alternative to suture for mesh fixation in Lichtenstein repair .