Laparoscopic intraperitoneal onlay mesh repair of ventral hernias– comparison between study of tacker vs glue fixation

Background: The open technique of ventral hernia repair involved extensive dissection of surrounding tissues, which led to complications, such as wound infections, seroma formation, etc. To overcome these, laparoscopic techniques were devised. In 1991, LeBlanc and Booth described their experience with repair of incisional hernia using expanded polytetrafluoroethylene prosthetic graft using laparoscopic technique. Ever since its introduction, the trend is toward attempting a laparoscopic repair of ventral hernias. In this technique, the contents of the hernia sac are reduced and a prosthetic mesh is placed intraperitoneally/preperitoneally extending beyond the borders of the fascial defect and held in place by either staples sutures or glue. The information regarding which technique is more beneficial for the patient is still not completely proven. Hence the need for this comparative prospective study of laparoscopic intraperitoneal onlay mesh fixation using tacker and glue.
Methods: This study is aimed at comparing 50 patients of ventral hernias, selected randomly from patients admitted to the Krishna Institute of Medical Sciences, Karad, India, between the period September 2017 and March 2019.
Result: In this study, 22 (44%) out of 50 cases were females, whereas 28 (56%) cases were males, which shows a higher incidence inmales. In this study, the mean duration of surgery was 78.66 minutes in the glue fixation group, which was significantly more (p=0.000) than the tacker fixation group where mean duration of surgery was 61.55 minutes. Patients with tacker fixation took more time to return to normal activities like ambulation, personal dressing, and toilet use, with mean of 3 ± 0.6 days as compared with 1 ± 0.58days in gluefixation group, which is statistically significant (p < 0.005). Cost of glue fixation is 50% less as compared with tacker fixation owing to the added cost of tacker.
Conclusions: Mesh fixation with glue in LVHR was associated with less postoperative discomfort and pain