Comparative Study of Tacker vs Glue Fixation of Mesh in Laparoscopic Intraperitoneal Onlay Mesh Repair of Ventral Hernias

Abstract

Aim:To compare results of tacker and glue fixation of mesh in laparoscopic intraperitoneal onlay mesh repair of ventral hernias. Materials and methods:Patients admitted to the General Surgery Department of Sir Jamshedjee Jeejeebhoy Group of Hospitals, Mumbai, India, from January 2015 to June 2016 for ventral hernia repair were included for the study. A total of 60 patients were enrolled, and each group consisted of 30 cases. Results:In our study, the mean age of ventral hernia patients subjected for glue fixation was found to be 38 years and for tacker fixation it was found to be 38.77 years. There is no statistically significant difference among the age of cases in the two groups in terms of mean age (p = 0.75). Out of 60 cases, 28 (46.66%) were females, whereas 32 (53.33%) cases were males. Maximum size of hernia defect was restricted to 6 cm. The mean size of hernia defect was 2.84 ± 1.02 cm in the glue fixation group, while that in the tacker fixation group was 3.15 ± 0.731 cm. Mean duration of surgery was 83.67 minutes in the glue fixation group and 64.50 minutes in the tacker fixation group. There was no intraoperative and postoperative complications with glue fixation. In tacker fixation, seroma was seen in 4 cases (13.33%), hematoma in 1 (3%), bowel ileus in 1 (3%), whereas there were no intra-abdominal complications, bowel obstruction, bleeding from trocar site, and enterocutaneous fistula. The mean pain [visual analog scale (VAS) score] of glue fixation and tacker fixation at 24 hours was 1 and 2.23 respectively. Mean postoperative hospital stay for patients with tacker fixation is 3 days, and 2 days in glue fixation. Mean time to return to normal activities was 3 ± 0.6 days in tacker fixation group and 1 ± 0.58 days in glue fixation group. No recurrence was found in both groups of fixation methods. Conclusion:Mesh fixation with glue is better as compared with tacker in terms of cost, postoperative pain, and length of hospital stay; however, the use of tacker or glue depends on surgeon preference, patient affordability, and availabilities of facilities.