title: Gallbladder perforation by absorbable spiral tacker.
abstract: BACKGROUND
  Mesh fixation with tacker systems is common in laparoscopic and open hernia repair. Complications due to absorbable tackers are rare and have not been described in the literature. However, we report a case of gallbladder erosion due to tacker dislocation.
  
  
  METHODS
  An open hernia repair was performed using an intraperitoneal onlay mesh for a recurrent parastomal hernia after two previous mesh repairs in a 67-year-old patient.
  
  
  RESULTS
  On postoperative day 2, the patient was reoperated because of a dislocated tacker that eroded and perforated the fundus region of the gallbladder. Putatively, tacker dislocation occurred owing to imbalanced traction forces. Initially, the mesh was fixed with absorbable tackers around the stoma on the right and transmuscular suture fixation was carried out on the left abdominal side. On revision surgery, tension forces to the right were therefore neutralised by additional transmuscular sutures on the right side.
  
  
  CONCLUSIONS
  Absorbable tackers in open hernia repair provide a safe and effective mesh fixation if tension forces are carefully avoided.
authors.affiliation: University Hospital Zurich, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Wirsching
authors.forename: R
authors.initials: R
authors.lastname: Vonlanthen
authors.forename: K
authors.initials: K
authors.lastname: Lehmann
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D005704:Gallbladder / Q000293:injuries*; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D012008:Recurrence; D018570:Risk Assessment; D013526:Surgical Mesh / Q000009:adverse effects*; D054047:Surgical Stomas; D013536:Suture Techniques / Q000009:adverse effects* / Q000295:instrumentation*; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000209:etiology*