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Original Article



Comparison of outcome in Patients Undergoing Laparoscopic repair of Ventral Hernias using Tackers and Intra corporeal Sutures for Mesh fixation - A Retrospective Study

Venkatesh S P, Radhakrishna V, Sattishh Egappan AR, Deepika Lakshminarayanan.




Abstract
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Introduction: Ventral hernia is a common surgical problem for which both open and laparoscopic repair is being practised. Laparoscopic ventral hernia repair is the recommended procedure of choice. Though there are options available to fix the mesh such as tackers, intracorporeal sutures and transfascial sutures, no specific technique has been advocated as the best method to fix the mesh. Hence this study was taken up to compare the overall outcome of patients undergoing laparoscopic repair of ventral hernias using tackers and intracorporeal sutures for mesh fixation.
Methodology: This study is a retrospective study done in a Postgraduate Medical College in Puducherry. Patients who underwent Intraperitoneal on lay mesh repair (IPOM) From January 2017 to July 2021 (50 patients) were included in the study. Patients were divided into 2 groups (1) the sutures group (25 patients), and (2) the tackers group (25 patients). Patient details, Type of ventral hernia, Intraoperative mesh fixation technique, Duration of Surgery, Total Expenditure, and Postoperative pain assessment using the Numeric pain intensity scale were recorded from case sheets. Analysis was performed with SPSS and reviewed by a statistician.
Conclusion: The best method for mesh fixation in IPOM repair remains controversial. We compared the outcome in patients undergoing IPOM using tackers and intracorporeal sutures for mesh fixation and found that the tackers group had a shorter duration of surgery, more postoperative pain, higher cost of surgery, longer duration of hospital stay compared to the intracorporeal suture group. We conclude that fixation of mesh in Laparoscopic ventral hernia repair using sutures is more cost-effective than tackers.

Key words: Laparoscopic ventral hernia repair, IPOM, tackers, intracorporeal sutures






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