Surgical Endoscopy

, Volume 25, Issue 5, pp 1431–1438 | Cite as

A prospective randomized study comparing suture mesh fixation versus tacker mesh fixation for laparoscopic repair of incisional and ventral hernias

  • Virinder Kumar BansalEmail author
  • Mahesh C. Misra
  • Subodh Kumar
  • Y. Keerthi Rao
  • Paras Singhal
  • Amit Goswami
  • Sandeep Guleria
  • M. K. Arora
  • Anjolie Chabra



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 with four corner transfascial sutures versus transfascial sutures alone.

Materials and methods

68 patients admitted for LIVHR repair (defect size less than 25 cm2) were randomized in two groups: group I, tacker fixation (36 patients) and group II, suture fixation (32 patients). Various intraoperative variables and postoperative outcomes were recorded and analyzed.


The patients in the two groups were well matched in terms of age, sex, body mass index (BMI), and hernia characteristics. Mean BMI was 29.0 kg/m2. Operative time was found to be significantly higher in group II (77.5 versus 52.6 min, p = 0.000). Patients in group I were found to have significantly higher pain scores at 1 h, 6 h, 24 h, 1 week, 1 month, and 3 months postoperatively. At follow-up, incidence of seromas was higher in group II but the difference was not significant (7 versus 4, p = 0.219). During long-term follow-up, patients in group II were satisfied cosmetically.


Suture fixation is a cost-effective alternative to tacker fixation, for small and medium-sized defects in anatomically accessible areas. However, suture fixation requires significantly longer operation time, but patients have statistically significantly less postoperative pain.


Laparoscopic Incisional hernia Mesh fixation Tackers Suture fixation Pain score 



Authors Virinder Kumar Bansal, Mahesh C Misra, Subodh Kumar, Y Keerthi Rao, Paras Singhal, Amit Goswami, Sandeep Guleria, M K Arora, and Anjolie Chabra have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Virinder Kumar Bansal
    • 1
    Email author
  • Mahesh C. Misra
    • 1
  • Subodh Kumar
    • 1
  • Y. Keerthi Rao
    • 1
  • Paras Singhal
    • 1
  • Amit Goswami
    • 1
  • Sandeep Guleria
    • 1
  • M. K. Arora
    • 2
  • Anjolie Chabra
    • 2
  1. 1.Department of Surgical DisciplinesAll India Institute of Medical SciencesNew DelhiIndia
  2. 2.Department of AnesthesiologyAll India Institute of Medical SciencesNew DelhiIndia

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