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Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation

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Abstract

Background

Mesh fixation during laparoscopic ventral hernia repair can be performed using transfascial sutures or metal tacks. The aim of the present study is to compare mesh shrinkage and pain between two different techniques of mesh fixation in a prospective randomized trial.

Methods

A randomized trial was performed. Patients with ventral hernia of maximal diameter 8 cm were assigned to mesh fixation using either transfascial nonabsorbable sutures or metal tacks for fixation of a parietene composite mesh. The borders of the mesh were marked using clips, and radiological images in prone position were used for assessment of mesh size and location. The primary endpoint was mesh shrinkage; secondary endpoints included postoperative pain, mesh dislocation, and surgical morbidity.

Results

Demographic parameters were similar in both groups. A total of 40 patients were randomized, and 36 patients were available for follow-up. There was one hernia recurrence in each group. Pain was significantly higher following suture fixation after 6 weeks, but no difference was found after 6 months. Mesh shrinkage after 6 months was significantly higher using tacks for mesh fixation.

Conclusions

Transfascial sutures are associated with more pain within the first 6 postoperative weeks and less mesh shrinkage after 6 months compared with mesh fixation using metal tacks.

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Acknowledgements

The study was funded by Sofradim/Covidien. We thank Brigitte Wanner for meticulous data collection, control of data, and analysis of radiographs.

Disclosures

Authors Guido Beldi, Markus Wagner, Lukas E. Bruegger, Anita Kurmann, and Daniel Candinas have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, 3010, Bern, Switzerland

    Guido Beldi, Markus Wagner, Lukas E. Bruegger, Anita Kurmann & Daniel Candinas

Authors
  1. Guido Beldi
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  2. Markus Wagner
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  3. Lukas E. Bruegger
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  4. Anita Kurmann
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  5. Daniel Candinas
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Corresponding author

Correspondence to Guido Beldi.

Additional information

Guido Beldi and Markus Wagner contributed equally to this work.

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Beldi, G., Wagner, M., Bruegger, L.E. et al. Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation. Surg Endosc 25, 749–755 (2011). https://doi.org/10.1007/s00464-010-1246-0

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  • DOI: https://doi.org/10.1007/s00464-010-1246-0

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