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A prospective randomized study comparing suture mesh fixation versus tacker mesh fixation for laparoscopic repair of incisional and ventral hernias

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Abstract

Introduction

After the first report of laparoscopic incisional and ventral hernia repair (LIVHR) in 1993, several studies have proven its efficacy over open method. Among the technical issues, the technique of mesh fixation to the abdominal wall is still an area of debate. This prospective randomized study was done to compare two techniques of mesh fixation, i.e., tacker with four corner transfascial sutures versus transfascial sutures alone.

Materials and methods

68 patients admitted for LIVHR repair (defect size less than 25 cm2) were randomized in two groups: group I, tacker fixation (36 patients) and group II, suture fixation (32 patients). Various intraoperative variables and postoperative outcomes were recorded and analyzed.

Results

The patients in the two groups were well matched in terms of age, sex, body mass index (BMI), and hernia characteristics. Mean BMI was 29.0 kg/m2. Operative time was found to be significantly higher in group II (77.5 versus 52.6 min, p = 0.000). Patients in group I were found to have significantly higher pain scores at 1 h, 6 h, 24 h, 1 week, 1 month, and 3 months postoperatively. At follow-up, incidence of seromas was higher in group II but the difference was not significant (7 versus 4, p = 0.219). During long-term follow-up, patients in group II were satisfied cosmetically.

Conclusion

Suture fixation is a cost-effective alternative to tacker fixation, for small and medium-sized defects in anatomically accessible areas. However, suture fixation requires significantly longer operation time, but patients have statistically significantly less postoperative pain.

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Disclosures

Authors Virinder Kumar Bansal, Mahesh C Misra, Subodh Kumar, Y Keerthi Rao, Paras Singhal, Amit Goswami, Sandeep Guleria, M K Arora, and Anjolie Chabra have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, Room No. 5021, 5th Floor, Teaching Block, New Delhi, India

    Virinder Kumar Bansal, Mahesh C. Misra, Subodh Kumar, Y. Keerthi Rao, Paras Singhal, Amit Goswami & Sandeep Guleria

  2. Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India

    M. K. Arora & Anjolie Chabra

Authors
  1. Virinder Kumar Bansal
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  2. Mahesh C. Misra
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  3. Subodh Kumar
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  5. Paras Singhal
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  6. Amit Goswami
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  7. Sandeep Guleria
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  9. Anjolie Chabra
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Corresponding author

Correspondence to Virinder Kumar Bansal.

Additional information

Presented at the 12th WCES, April 14--17, 2010, National Harbor, MD.

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Bansal, V.K., Misra, M.C., Kumar, S. et al. A prospective randomized study comparing suture mesh fixation versus tacker mesh fixation for laparoscopic repair of incisional and ventral hernias. Surg Endosc 25, 1431–1438 (2011). https://doi.org/10.1007/s00464-010-1410-6

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  • DOI: https://doi.org/10.1007/s00464-010-1410-6

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