Comparison of peritoneal closure techniques in laparoscopic transabdominal preperitoneal inguinal hernia repair: a prospective randomized study.
OBJECTIVE
We aimed to compare tacker and suture techniques for peritoneal closure with respect to patient outcomes.


METHODS
A total of 64 patients were included in the study, 32 being in the tacker group and 32 in the suture group. All patients underwent laparoscopic TAPP inguinal hernia repair. Both groups were compared with respect to age, sex, duration of peritoneal closure and the operation, hernia type, the number of tackers used for mesh fixation, postoperative complication rate, visual analogue scale (VAS) scores on 1st, 7th, and 30th days, duration of follow-up, and recurrence rates.


RESULTS
Duration of peritoneal closure and the operation was significantly shorter in the tacker group compared to the suture group (p < 0.001, p = 0.008, respectively). Statistical analysis with the two-way analysis of variance method revealed that mesh fixation with one or two tackers did not influence postoperative pain. VAS 1 was significantly lower in patients with peritoneal closure with suture compared to the patients undergoing peritoneal closure with tacker (p = 0.027). VAS 7 and VAS 30 were lower for peritoneal closure with suture versus tacker, although the difference did not reach statistical significance (p = 0.064, p = 0.294, respectively). We observed no recurrence at an average of 21-month follow-up.


CONCLUSIONS
Tacker and suture appeared to have a comparable safety for peritoneal closure in laparoscopic TAPP inguinal hernia operation. It can be suggested that peritoneal closure with tacker increased short-term pain, independent of the number of tackers used for mesh fixation. Long-term pain was similar in both groups.
Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey.
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Oguz
Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey. erenka2000@hotmail.com.|Baskent Universitesi Konya Hastanesi Hocacihan Mah, Saray caddesi No:1, Selcuklu/Konya, 42080, Turkey. erenka2000@hotmail.com.
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Karagulle
Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey.
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Turk
Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey.
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Moray
D000328:Adult; D000368:Aged; D005260:Female; D006550:Hernia, Femoral / Q000601:surgery*; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000601:surgery*; D011446:Prospective Studies; D016037:Single-Blind Method; D013526:Surgical Mesh; D013536:Suture Techniques; D013537:Sutures
Inguinal hernia; Laparoscopic inguinal hernia repair; Peritoneal closure method; Suture; Tacker; Transabdominal preperitoneal inguinal hernia repair