# Efficacy of Cyanoacrylate Tissue Adhesive for Closure of Laparoscopic Trocar Sites: A Single-Center, Prospective, Cohort Study

## TL;DR

This study evaluates the effectiveness of cyanoacrylate adhesive for closing laparoscopic trocar sites in Indian patients, showing promising results in terms of time and cost.

## Contribution

The study provides novel evidence on cyanoacrylate tissue adhesive efficacy in Indian surgical settings with unique demographic and resource contexts.

## Key findings

- Cyanoacrylate adhesive achieved complete hemostasis in 85.95% of patients.
- Wound dehiscence and discharge occurred in only 2.63% of patients.
- Closure time increased with the number of ports used, ranging from 20 to 90 seconds.

## Abstract

Background

The application of tissue adhesives in the closure of laparoscopic trocar sites has been extensively studied in Western populations. However, evidence from India is scarce despite significant differences in patient demographics, surgical practices, and resource availability.

Methods

A prospective, single-center, cohort study was conducted at a tertiary care center from November 2022 to July 2025. Patients eligible to undergo an elective laparoscopic procedure and trocar site closure with n-butyl-cyanoacrylate tissue adhesive were included in this study. The primary co-endpoints of the study were wound closure time, cost-effectiveness, and wound dehiscence.

Results

A total of 114 patients were included in this analysis, of which 68 (59.64%) were male. The majority of the patients, i.e., 32 (28.07%), belonged to the 21-30 years age group. The most common type of laparoscopic surgery was appendectomy, performed in 60 (52.63%) patients. The port size was 5 mm in 165 (45%) patients and 10 mm in 202 (55%) patients. The mean closure time increased with the number of ports, from 20 seconds in single-port closures to 90 seconds in five-port closure surgeries. Complete hemostasis was achieved in 98 (85.95%) patients. Postoperative complications such as wound dehiscence and discharge were observed in three (2.63%) patients. The tissue adhesive cost was 300 INR (approximately 3.5 USD) for 15 ml.

Conclusion

Surgical adhesives have been emerging as a viable alternative to suturing in small incisions, such as laparoscopic trocar sites.