Vol. 7, Issue 2, Part A (2025)

Background: Laparoscopic Intra-Peritoneal Onlay Mesh (IPOM) repair is widely used for ventral hernia repair due to its minimally invasive approach and favorable outcomes. However, the optimal technique for mesh fixation whether using sutures or tackers remains debated, particularly with respect to pain outcomes, cost-effectiveness, and procedural time.
Objective: To compare the clinical outcomes, postoperative pain, operative time, and complication rates between mesh fixation with non-absorbable sutures versus absorbable tackers in laparoscopic IPOM repair.
Methods: In this prospective, randomized controlled study conducted at a tertiary care center from January 2023 to June 2024, 60 adult patients with uncomplicated ventral hernias were randomly assigned to undergo mesh fixation using either sutures (N=30) or tackers (N=30). Operative time, mesh fixation time, postoperative pain (VAS scores), duration of analgesia requirement, and complication rates were assessed. Data were analyzed using SPSS v25.0 with p<0.05 considered statistically significant.
Results: Baseline demographic and clinical variables were statistically comparable in both groups. Mean mesh fixation time was significantly shorter in the tacker group (24.3±5.4 min) versus the suture group (39.7±9.8 min; p<0.001). However, VAS score and rescue analgesia requirements were significantly higher in the tacker group (66.7% vs. 26.7%; p<0.001). No significant differences were observed in surgical site infection or early complication rates. By 3 months, pain scores had decreased to negligible levels in both groups.
Conclusion: Tackers are associated with shorter operative times but significantly greater early postoperative pain compared to sutures. Suture fixation may be preferred for enhanced patient comfort in the early recovery phase.