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

M S Sajid, U Parampalli, M R McFall
Hernia: the Journal of Hernias and Abdominal Wall Surgery 2013, 17 (2): 159-66

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.

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