Dr. Madhushankar.L, Dr. Amrith Preetam Panda
Abstract: Aim and Objectives: After the first report of laparoscopic incisional and ventral hernia repair (LIVHR) in 1993, several studies have proven its efficacy over open method. Among the technical issues, the technique of mesh fixation to the abdominal wall is still an area of debate. This prospective randomized study was done to compare two techniques of mesh fixation, i.e., tacker only versus trans-fascial sutures alone with respect to pain scores. Materials and Methods: 40 patients admitted for LIVHR repair (defect size less than 25cm2) were randomized in two groups: group T, tacker fixation (20 patients) and group S, suture fixation (20 patients). Patients in the two groups were well matched in terms of age, sex and hernia characteristics. Follow up was performed in the outpatient clinic with questioning and clinical evaluation after discharge on day 7, day 10 and 3 months for VAS scores. Results: Patients in group T were found to have significantly lower pain scores at day 1, day 3, at 1 week and 3 months as compared to group S resulting in shorter hospital stay and early recovery. During long-term follow-up, patients in group T were satisfied cosmetically. There was no recurrence in either of the group studied. Conclusions: Laparoscopic ventral hernia repair with tacker only mesh fixation is safe and convenient way for treatment of abdominal wall hernia and its results in respect of surgical outcomes and recurrences are comparable to any other method of ventral hernias surgery.
Keywords: LVHR, tackers, sutures, IPOM, mesh fixation