NICE Guidance Recommends Move to Glues in Hernia Operations

13 July 2022

New guidance from the National Institute for Care and Excellence (NICE) is recommending clinicians consider the use of specialist glues instead of tacks to secure surgical mesh in hernia operations.

The NICE MedTech Innovation Briefing guidance has been issued following a Value Based Procurement project carried out by NHS Supply Chain’s Sterile Intervention and Associated Consumables team.

Each year 70,000 hernia operations are carried out in the UK but currently only 10% use glues to secure surgical mesh. The majority use either metal or plastic tackers instead.

The briefing says that by using glues instead, potential benefits include:

  • Reduced postoperative and chronic pain
  • Fewer postoperative complications, such as nerve injury
  • Reduced risk of hernia recurrence
  • Reduced length of hospital stays, with the financial savings that brings
  • Earlier return to work and usual activities
  • Improved patient quality of life.

This is a really significant guidance document because of the improvements it offers to the patient pathway… The guidance makes clear the many benefits that patients will get from this change and ultimately that is what all of us in the NHS are here to do so this is a game changer from that perspective alone. The glue eventually disappears within the body whereas with a tacker you have something in your body and that always has the potential for something to cause pain at a later point.

Rob Wilcockson, Senior Category Manager, NHS Supply Chain

Ian Dodd, Clinical Engagement and Implementation Manager for NHS Supply Chain, feels the guidance is just the first part of the story as there are other knock-on financial or efficiency benefits by switching from tackers to glue.

There are millions of pounds of savings to be made nationally by preventing patients returning to GPs or hospitals with pain caused by the tackers put in their bodies during a hernia operation… That improves the lives of patients but also has financial savings from the prevented repeat appointments and frees up the time of those clinicians to deal with other patients.

Ian Dodd, Clinical Engagement and Implementation Manager, NHS Supply Chain

Glues that meet the standards in the NICE MedTech Innovation Briefing are available through NHS Supply Chain’s Surgical Mesh Framework.
See our Useful Links section for more information.

This project shows the benefits that come from a Value Based Procurement approach by taking a holistic view of a patient pathway, analysing the improvements that can be made and thinking of all the knock-on benefits in the process through making a relatively simple change in clinical practice.

Brian Mangan, Value Based Procurement Project Lead, NHS Supply Chain