Skip to main content
Log in

A meta-analysis comparing tacker mesh fixation with suture mesh fixation in laparoscopic incisional and ventral hernia repair

Hernia Aims and scope Submit manuscript

Abstract

Objective

To systematically compare the tacker mesh fixation (TMF) with the suture mesh fixation (SMF) in laparoscopic incisional and ventral hernia (LIVH) repair.

Methods

Trials evaluating the TMF with the SMF in LIVH repair were analysed using the statistical tool RevMan®. Combined dichotomous and continuous data were expressed as odds ratio (OR) and mean difference (MD), respectively.

Results

Four trials (2 randomised and 2 non-randomised) encompassing 207 patients undergoing LIVH repair with TMF versus SMF were retrieved from the standard electronic databases and analysed systematically. Ninety-nine patients underwent TMF and 108 patients underwent SMF in LIVH repair. There was no statistically significant heterogeneity (p = 0.27)] among trials. In the fixed-effects model, LIVH repair with TMF was associated with shorter operation time (MD, −23.65; 95 % CI, −31.06, −16.25; z = 6.26; p < 0.00001). Four- to six-week postoperative pain score was significantly lower (MD, −0.69; 95 % CI, −1.16, −0.23; z = 2.92; p < 0.004) following TMF. Peri-operative complications (p = 0.65), length of hospital stay (p = 1) and risk of hernia recurrence (OR, 1.54; 95 % CI, 0.38, 6.27; z = 0.61; p = 0.54) following TMF and SMF were statistically not different.

Conclusion

TMF in LIVH repair is associated with shorter operative time and lesser postoperative pain. TMF is comparable with SMF in terms of peri-operative complications, length of hospital stay and hernia recurrence. Therefore, TMF may be used in LIVH repair. However, further randomised trials recruiting higher number of patients are required to validate these findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Lomanto S, Iyer G, Shabbir A, Cheah WK (2006) Laparoscopic versus open ventral hernia mesh repair: a prospective study. Surg Endosc 20:1030–1035

    Article  PubMed  CAS  Google Scholar 

  2. Mudge M, Hughes LE (1985) Incisional hernia: a 10-year prospective study of incidence and attitudes. Br J Surg 72:70–71

    Article  PubMed  CAS  Google Scholar 

  3. Lewis RT, Wiegand FM (1989) Natural history of vertical abdominal parietal closure: prolene versus dexon. Can J Surg 32:196–200

    PubMed  CAS  Google Scholar 

  4. Hoer J, Lawong G, Klinge U (2002) Factors influencing the development of incisional hernia: a retrospective study of 2983 laparotomy patients over a period of 10 years. Chrirug 73:474–480

    Article  CAS  Google Scholar 

  5. Franchi M, Ghezzi F, Buttarelli M, Tateo S, Balestreri D, Bolis P (2001) Incisional hernia in gynaecologic oncology patients: a 10-year study. Obstet Gynecol 97(5 Pt 1):696–700

    Article  PubMed  CAS  Google Scholar 

  6. Sørensen LT, Hemmingsen UB, Kirkeby LT, Kallehave F, Jørgensen LN (2005) Smoking is a risk factor for incisional hernia. Arch Surg 140:119–123

    Article  PubMed  Google Scholar 

  7. National Centre for Health Statistics (1996) Combined surgery data (NHDS and NSAS) data highlights. Available at: http://www.cdc.gov/nchs/about/major/hdasd

  8. Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M (2011) Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev 16(3):CD007781

    Google Scholar 

  9. Forbes SS, Eskicioglu C, McLeod RS, Okrainec A (2009) Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg 96:851–858

    Article  PubMed  CAS  Google Scholar 

  10. Goodney PP, Birkmeyer JD (2002) Short term outcomes of laparoscopic and open ventral hernia repair: a meta-analysis. Arch Surg 137:1161–11655

    Article  PubMed  Google Scholar 

  11. Kapischke M, Schulz T, Schipper T, Tensfeld J, Caliebe A (2008) Open versus laparoscopic incisional hernia repair: something different from a meta-analysis. Surg Endosc 22:2251–2260

    Article  PubMed  Google Scholar 

  12. Müller-Riemenschneider F, Roll S, Friedrich M, Zieren J, Reinhold T, von der Schulenburg JM, Greiner W, Willich SN (2007) Medical effectiveness and safety of conventional compared to laparoscopic incisional hernia repair: a systematic review. Surg Endosc 21:2127–2136

    Article  PubMed  Google Scholar 

  13. Pham CT, Perera CL, Watkin DS, Maddern GJ (2009) Laparoscopic ventral hernia repair: a systematic review. Surg Endosc 23:4–15

    Article  PubMed  Google Scholar 

  14. Sajid MS, Bokhari SA, Mallick AS, Cheek E, Baig MK (2009) Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg 197:64–72

    Article  PubMed  Google Scholar 

  15. Wassenaar E, Schoenmaeckers E, Raymakers J, van der Palen J, Rakic S (2010) Mesh-fixation method and pain and quality of life after laparoscopic ventral or incisional hernia repair: a randomized trial of three fixation techniques. Surg Endosc 24:1296–1302

    Article  PubMed  Google Scholar 

  16. Costanza MJ, Heniford BT, Arca MJ, Mayes JT, Gagner M (1998) Laparoscopic repair of recurrent ventral hernias. Am Surg 64:1121–1125

    PubMed  CAS  Google Scholar 

  17. Samuel K, Miller SK, Carey SD, Rodriguez FJ, Smoot RT Jr (2003) Complications and their management. In: LeBlanc KA (ed) Laparoscopic hernia surgery: an operative guide. Arnold, London, pp 161–169

    Google Scholar 

  18. Eriksen JR, Poornoroozy P, Jørgensen LN, Jacobsen B, Friis-Andersen HU, Rosenberg J (2009) Pain, quality of life and recovery after laparoscopic ventral hernia repair. Hernia 13:13–21

    Article  PubMed  CAS  Google Scholar 

  19. Bansal VK, Misra MC, Kumar S, Keerthi Rao Y, Singhal P, Goswami A, Guleria S, Arora MK, Chabra A (2011) A prospective randomized study comparing suture mesh fixation versus tacker mesh fixation for laparoscopic repair of incisional and ventral hernias. Surg Endosc 25:1431–1438

    Article  PubMed  Google Scholar 

  20. Beldi G, Wagner M, Bruegger LE, Kurmann A, Candinas D (2011) Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation. Surg Endosc 25:749–755

    Article  PubMed  Google Scholar 

  21. Greenstein AJ, Nguyen SQ, Buch KE, Chin EH, Weber KJ, Divino CM (2008) Recurrence after laparoscopic ventral hernia repair: a prospective pilot study of suture versus tack fixation. Am Surg 74:227–231

    PubMed  Google Scholar 

  22. Nguyen SQ, Divino CM, Buch KE, Schnur J, Weber KJ, Katz LB, Reiner MA, Aldoroty RA, Herron DM (2008) Postoperative pain after laparoscopic ventral hernia repair: a prospective comparison of sutures versus tacks. JSLS 12:113–116

    PubMed  Google Scholar 

  23. Lepere M, Benchetrit S, Bertrand JC, Chalbet JY, Combier JP, Detruit B, Herbault G, Jarsaillon P, Lagoutte J, Levard H, Rignier P (2008) Laparoscopic resorbable mesh fixation. Assessment of an innovative disposable instrument delivering resorbable fixation devices: I-Clip(TM). Final results of a prospective multicentre clinical trial. Hernia 12:177–1783

    Article  PubMed  CAS  Google Scholar 

  24. Clarke T, Katkhouda N, Mason RJ, Cheng BC, Algra J, Olasky J, Sohn HJ, Moazzez A, Balouch M (2011) Fibrin glue for intraperitoneal laparoscopic mesh fixation: a comparative study in a swine model. Surg Endosc 25:737–748

    Article  PubMed  Google Scholar 

  25. van’t Riet M, de Vos van Steenwijk PJ, Kleinrensink GJ, Steyerberg EW, Bonjer HJ (2002) Tensile strength of mesh fixation methods in laparoscopic incisional hernia repair. Surg Endosc 16:1713–1716

    Article  Google Scholar 

  26. Karakousis CP, Volpe C, Tanski J, Colby ED, Winston J, Driscoll DL (1995) Use of a mesh for musculoaponeurotic defects of the abdominal wall in cancer surgery and the risk of bowel fistulas. J Am Coll Surg 181:11–16

    PubMed  CAS  Google Scholar 

  27. Kaufman Z, Engelberg M, Zager M (1981) Fecal fistula: a late complication of Marlex mesh repair. Dis Colon Rectum 24:543–544

    Article  PubMed  CAS  Google Scholar 

  28. Wassenaar EB, Raymakers JT, Rakic S (2008) Impact of the mesh fixation technique on operation time in laparoscopic repair of ventral hernias. Hernia 12:23–25

    Article  PubMed  CAS  Google Scholar 

  29. Kurian A, Gallagher S, Cheeyandira A, Josloff R (2010) Predictors of in-hospital length of stay after laparoscopic ventral hernia repair: results of multivariate logistic regression analysis. Surg Endosc 24:2789–2792

    Article  PubMed  Google Scholar 

  30. Barzana D, Johnson K, Clancy TV, Hope WW (2010) Hernia recurrence through a composite mesh secondary to transfascial suture holes. Hernia Sep 12 (Epub ahead of print)

  31. Higgins JPT, Green S (eds) (2008) Cochrane handbook for systematic reviews of interventions Version 5.0.0 (updated February 2008). The Cochrane Collaboration. http://www.cochrane-handbook.org. Accessed 15 April 2011

  32. Review Manager (RevMan) [Computer program]. Version 5.0. The Nordic Cochrane Centre, The Cochrane Collaboration: Copenhagen, 2008

  33. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188

    Article  PubMed  CAS  Google Scholar 

  34. DeMets DL (1987) Methods for combining randomized clinical trials: strengths and limitations. Stat Med 6:341–350

    Article  PubMed  CAS  Google Scholar 

  35. Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558

    Article  PubMed  Google Scholar 

  36. Egger M, Smith GD, Altman DG (2006) Systematic reviews in healthcare. BMJ Publishing, London

    Google Scholar 

  37. Deeks JJ, Altman DG, Bradburn MJ (2001) Statistical methods for examining heterogeneity and combining results from several studies in meta-analysis. Systemic reviews in health care: meta-analysis in context, 2nd edn. BMJ Publication group, London

    Google Scholar 

  38. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12

    Article  PubMed  CAS  Google Scholar 

  39. Chalmers TC, Smith H Jr, Blackburn B, Silverman B, Schroeder B, Reitman D (1981) A method for assessing the quality of a randomized control trial. Control Clin Trials 2:31–49

    Article  PubMed  CAS  Google Scholar 

  40. SIGN guidelines. Accessed 12 April 2011. Available from: http://www.sign.ac.uk/guidelines/fulltext/50/checklist3

  41. Rangel SJ, Kelsey J, Colby CE, Anderson J, Moss RL (2003) Development of a quality assessment scale for retrospective clinical studies in pediatric surgery. J Pediatr Surg 38:390–396

    Article  PubMed  Google Scholar 

  42. http://ims.cochrane.org/revman/other-resources/gradepro/download. Accessed 3 May 2011

Download references

Conflict of interest

None to declare.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. S. Sajid.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sajid, M.S., Parampalli, U. & McFall, M.R. A meta-analysis comparing tacker mesh fixation with suture mesh fixation in laparoscopic incisional and ventral hernia repair. Hernia 17, 159–166 (2013). https://doi.org/10.1007/s10029-012-1017-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-012-1017-z

Keywords

Navigation