title: Suture versus tack fixation of mesh in laparoscopic umbilical hernia repair.
abstract: OBJECTIVE
  Mesh fixation in laparoscopic umbilical hernia repair is poorly studied. We compared postoperative outcomes of laparoscopic umbilical hernia repair in suture versus tack mesh fixation.
  
  
  METHODS
  Patients who underwent laparoscopic umbilical hernia repair were separated by method of mesh fixation: sutures versus primarily tacks. Medical history and follow-up data were collected through medical records. The primary outcome of this study was the recurrence rates of hernias. Postoperative major and minor complications, such as surgical site infection, small-bowel obstruction, and seroma formation, were regarded as secondary outcomes. Additionally, a telephone interview was conducted to assess postoperative pain, recovery time, and overall patient satisfaction.
  
  
  RESULTS
  Eighty-six patients were identified: 33 in the suture group and 53 in the tacks group. The number of emergent cases was increased in the tacks group (6 vs 0; P = .022). Mean follow-up time was 2.7 years for both groups. Documented postoperative follow-up was obtained in 29 (90%) suture group and 31 (58%) tacks group patients. Hernia recurrence occurred in 3 and 2 patients in the sutures and tacks groups, respectively (P was not significant). No differences were found in secondary outcomes, including subjective outcomes from telephone interviews, between groups.
  
  
  CONCLUSIONS
  There are no differences in postoperative complication rates in suture versus tack mesh fixation in laparoscopic umbilical hernia repair.
authors.affiliation: Department of Surgery, Mount Sinai Hospital, New York, NY, USA.
authors.forename: Riley K
authors.initials: RK
authors.lastname: Kitamura
authors.affiliation: Department of Surgery, Mount Sinai Hospital, New York, NY, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Choi
authors.affiliation: Department of Surgery, Mount Sinai Hospital, New York, NY, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lynn
authors.affiliation: Department of Surgery, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1259, 5th Floor, New York, NY 10029. Celia.Divino@mountsinai.org.
authors.forename: Celia M
authors.initials: CM
authors.lastname: Divino
mesh_terms: D005260:Female; D006554:Hernia, Umbilical / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013526:Surgical Mesh; D013536:Suture Techniques / Q000009:adverse effects