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Comparative Study of Tacker versus Glue Fixation of Mesh In Laparoscopic Intra-peritoneal Onlay Mesh Repair Of Ventral Hernias

Eham Arora, MS1, Jalbaji More, MS1, Shubham Gupta, MS1, Jasmine Agarwal1, Gagandeep Talwar1, Chintan Patel, MS2. 1Grant Government Medical College & Sir J.J. Group of Hospitals, Mumbai, India, 2Kiran Multi-super Speciality Hospital and Research Centre, India

OBJECTIVE: The dilemma always persists regarding choice of fixation technique in ventral hernia. So we conducted a comparative prospective study of laparoscopic intraperitoneal onlay mesh fixation using Tacker and Glue.

METHOD: Sample size: 60 cases, 30 cases assigned randomly in two groups for either Tacker or Glue Fixation

Inclusion criteria: Patients between  18 -70 years of age, Patients with ventral hernias with defect size less than 6cm without any complications

Exclusion criteria: Patients with BMI >35, Patients with recurrence after previous repair or , Patients afflicted with COPD, LUTS, Prostatomegaly with complaints of nocturia, Patients unfit for general anesthesia, Patients with acute abdominal emergency.

The patients eligible for the study were selected, informed and explained regarding the above study and a proper informed, valid, written consent taken for participation in the study.

RESULTS: The mean duration of surgery was 83.67 minutes in the glue fixation group, which was significantly more than the tacker fixation group where mean duration of surgery was 64.50 minutes.

There was no intraoperative and postoperative complications with glue fixation.

In tacker fixation ,Seroma was seen in 4 cases(13.33%), hematoma in 1 (3%), bowel ileus in 1 (3%), whereas intra-abdominal complications, bowel obstruction, bleeding from trocar site, enterocutaneous fistula were 0 (0%). The glue fixation group did have a lesser complication rate 0/30(0%) as compared to 6/30 (20%) in tacker group.

The post-operative pain was recorded at 24 hrs, 48 hrs and 1 month after operation by using Visual Analogue Scale (VAS) pain scoring system. The mean pain score of glue fixation and tacker fixation  at 24 hrs was 1 and 2.23 respectively (p=0.00).

Median (range) post-operative hospital stay for patients with tacker fixation is 3 (2-4) days which is more as compared to 2 (1-3) in glue fixation which is statistically significant.

Cost of glue fixation is 50% less as compared to tacker fixation owing to the added cost of tacker.

CONCLUSION: Return to normal physical activity is earlier in patients with glue fixation.

  • Length of hospital stay was less in the glue fixation group
  • Cost of glue fixation is 50% less as compared to tacker fixation owing to the added cost of tacker.
  • Postoperative follow up upto 1 year doesn’t show any recurrence however, no data of efficiency with longer follow up are available.

Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87292

Program Number: P040

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

61

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