Laparoscopic ventral hernia repair: Comparison of tacker v/s Monofilament suture

Dr Latif Bagwan,Dr K Sendhil Kumar,Dr Piyush Patwa

doi:10.17511/ijoso.2020.i03.13

Dr Latif Bagwan, Dr K Sendhil Kumar + Show 1 more

Open Access

https://doi.org/10.17511/ijoso.2020.i03.13

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Abstract

Introduction: Hernias may be generally defined as a protrusion of abdominal viscera outside the abdominal cavity through a natural or acquired defect. Transracial sutures penetrate all layers of the abdominal wall, thereby enable fixation of the mesh to the entire fasciomuscular layer of the abdominal wall. In the present study, a comparison between the two most common methods of mesh fixation, i.e. tackers versus sutures was done. Materials and Methods: The totals of 100 patients were included in the study. The study was conducted in the department of the surgery for a period of one year. All the included patients were admitted for laparoscopic repair of primary or ventral hernia. All the patients included in the study were divided into two groups. Group A: patients with tacker fixation and Group B: Suture mesh fixation. Results: Although all the patients in the study presented with swelling in the abdominal region, associated pain was present in 56 of patients, 28 presented with irreducibility, 10 with obstruction, and only 6 patients showed the features of strangulation. The operative time was significantly higher in Group II. Patients in Group I experience more pain post-operatively. The incidence of seromas was higher in Group II. The cost of surgery was significantly higher in Group I compared to Group II. Conclusion: No major complications were encountered during or after the procedure. The formation of seromas was higher in suture fixation. In group A the use of tacks was costly as compared to group B. In the small-sized defect and in anatomical areas, the suture fixation was a better alternative as compared to tacker fixation.

Highlights

Hernias may be generally defined as a protrusion of abdominal viscera outside the abdominal cavity through a natural or acquired defect
Transracial sutures penetrate all layers of the abdominal wall, thereby enable fixation of the mesh to the entire fasciomuscular layer of the abdominal wall
The cost of surgery was significantly higher in Group I compared to Group II

Summary

Introduction

A protrusion of any saving in the laparoscopic repair of incisional and ventral hernias, the tensile strength of a mesh fixed by transfacial sutures is greater than when fixed by tacks [10]. Seventy-five the two most common methods of mesh fixation, i.e. tackers versus sutures was done. The of hernia, presenting symptoms, and associated inclusion criteria for the study were as below: small pre-existing medical illness helps give priority in size of the hernia defect, primary ventral hernias, admission to such patients. Some surgeons advocate that sutures are hypochondrium, a 12 mm laparoscopic port for a unnecessary for mesh fixation because of the. In Group I, mesh fixation was done with a 5 mm tacker (Protack, Autosuture, Tyco Healthcare, USA) along with 4 corners 1-0 polypropylene transfacial sutures. The operation time was measured from the skin incision given for Veres's needle insertion till complete closure of all port sites

Results

Discussion

Conclusion