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ORIGINAL ARTICLE
Year : 2013  |  Volume : 40  |  Issue : 2  |  Page : 84-89

Fixation in laparoscopic incisional hernia repair: Suture versus tacks


1 Department of Surgery, Peshawar Institute of Medical Sciences, Peshawar, Pakistan
2 Department of Surgery, Lady Reading Hospital, Peshawar, Pakistan

Correspondence Address:
Adil Bangash
Department of Surgery, Peshawar Institute of Medical Sciences, Peshawar
Pakistan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-5009.115476

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Aims and Objectives: To compare the frequency of complications of laparoscopic repair of incisional hernia using fixation of mesh with transabdominal sutures tacks. Materials and Methods: This study was conducted as part of an interventional multicenter trial at the Rehman Medical Institute, Peshawar, Peshawar Institute of Medical Sciences, and Pakistan Institute of Medical Science, Islamabad, from the 1 st of November 2008 till 31 st October 2011. The frequency of complications was calculated as the measure of comparing two methods of fixation in laparoscopic repair of incisional hernia using the IPOM technique. These patients were admitted via the outpatient department and their demographic data were collected on a pro forma basis. Forty-five patients were alternately placed in either group, and group I comprised patients with a ventral hernia that was fixed using spiral tacks whereas the other group was fixed with transabdominal sutures. A polytetraflouroethylene (Dual R ) mesh was applied in all cases. All data were collected onthe individual pro forma of each patient and was loaded on the SPSS R version 13.0. Results: The BMI in both groups was similar (P=0.94) The mean hospital stay was higher in the PTFE mesh group but the values were not significant (P=1.22).No perioperative death was observed in either group. One patient (2.2%) from group I was readmitted with varying complaints and was diagnosed as having subacute intestinal obstruction (P>0.05). A higher but insignificant recurrence rate was observed in the polyester group over a one-year period of follow-up. Three patients (6.6%) were diagnosed with recurrences in group I. Instead the PTFE group had a similar recurrence rate recurrence (P=1.00). Conclusion: The rate of recurrence in this study showed no significant difference by either mode of fixation. But statistically significant pain scores and increased operative time to fixation favors the use of tacks that limits to the few inner millimeters of the peritoneum.


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