title: A meta-analysis comparing tacker mesh fixation with suture mesh fixation in laparoscopic incisional and ventral hernia repair.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of General and Colorectal Surgery, Worthing Hospital, Washington Suite, North Wing, Worthing, West Sussex, BN11 2DH, UK. surgeon1wrh@hotmail.com
authors.forename: M S
authors.initials: MS
authors.lastname: Sajid
authors.forename: U
authors.initials: U
authors.lastname: Parampalli
authors.forename: M R
authors.initials: MR
authors.lastname: McFall
mesh_terms: D058107:Abdominal Wound Closure Techniques; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D010149:Postoperative Pain / Q000209:etiology; D012008:Recurrence; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome