Study on Early Postoperative Outcomes in Suture Versus Tacker Fixation of Mesh in TAPP

Dr. J. A. Jayalal, Dr. Selwyn J Kumar, Dr. Yuvaraj, Dr. Ajin Daniel, Dr. Sugeenthar

Abstract: Background: Laparoscopic methods for repairing inguinal hernias have greatly enhanced the outcomes of inguinal hernia surgery. The acute and chronic pain following mesh fixation with tacks and the high cost of these tacking devices remain significant barriers to the widespread adoption of laparoscopic transabdominal preperitoneal (TAPP) repair. This study aimed to propose a method for mesh fixation that could lower the expenses of laparoscopic TAPP repair and potentially alleviate postoperative pain. Objective: The purpose of this study was to compare suture versus tack fixation of the mesh in laparoscopic TAPP repair of inguinal hernias, so as to analyze differences in early postoperative outcomes such as pain, seroma, and urinary retention. Subjects and methods: A total of 30 patients aged between 18 and 60 years with inguinal hernia on either side and an American Society of Anaesthesiologists (ASA) score of I/II were part of this research. Those with a recurrent hernia, large scrotal hernia, strangulated and obstructed hernias, ASA III and ASA IV status, prostatism, and chronic cough were not included. Group A consisted of 15 patients (tack fixation group), whereas Group B comprised 15 patients (suture fixation group). The Visual Analogue Scale (VAS) serves as a tool for quantifying subjective experiences like pain intensity, anxiety, and other difficult - to - quantify sensations. Healthcare settings commonly use it for both clinical and research purposes. Results: We evaluated pain using a visual analogue scale during the early postoperative period and calculated the mean pain in two groups. We found that group A's mean pain score was 5, while group B's was 3. The p - value was less than 0.01 in POD 1, which is statistically significant. Conclusion: In our study, results suggest that suture fixation with mesh is less painful than tack fixation in the early postoperative period. There is no significant difference in hematoma and seroma formation in the early postoperative period.

Keywords: suture fixation, tack fixation, inguinal hernia, transabdominal preperitoneal repair