Short term outcome of “double crown� tackers mesh fixation vs intra-corporeal suture fixation in laparoscopic ventral hernia repair

Abstract

CONTEXT: Laparoscopic ventral hernia repair (LVHR) is a well recognized minimally invasive surgical technique for repair of different types of abdominal wall ventral hernias. Fixation of mesh in laparoscopic ventral hernia repair is most important step of surgery. But till date, we have not been able to reach on an any universal consensus in respect of finding any gold standard or at least so called, an ideal technique of mesh fixation. AIMS: The aim of this study is to compare the intra operative and post-operative outcomes between the two mesh fixation techniques : repair by intracorporeal sutures alone vs tackers alone. METHODS AND MATERIAL: 20 patients admitted for LVHR repair were randomized in two groups: group T, tacker fixation (10 patients) and group S, intra-corporeal suture fixation (10 patients). Various intraoperative variables and postoperative outcomes were recorded and analysed. The patients in the two groups were well matched in terms of age, sex and hernia characteristics STATISTICAL ANALYSIS USED: The variables were compared using chi-square test and un-paired students t test for qualitative and quantitative parameters as appropriate. A p value of <0.05 was considered significant RESULTS: Patients in group S were found to have significantly lower pain scores at day 1, day 3, 1 week, and 3 months than group T. There was less incidence of intra operative complications in the group S. Operative time was slightly more in group S as compared to group T CONCLUSIONS: Thus, intracorporeal suturing is a novel method of mesh fixation that can achieve secure fixation with reduced post-operative pain and significant lower cost to the patients.