title: Comparison of Absorbable Versus Nonabsorbable Tackers in Terms of Long-term Outcomes, Chronic Pain, and Quality of Life After Laparoscopic Incisional Hernia Repair: A Randomized Study.
abstract: BACKGROUND
  Laparoscopic incisional and ventral hernia repair (LIVHR) has been associated with a high incidence acute and chronic pain due to use of nonabsorbable tackers. Several absorbable tackers have been introduced to overcome these complications. This randomized study was done to compare 2 techniques of mesh fixation, that is, nonabsorbable versus absorbable tackers for LIVHR.
  
  
  METHODS
  Ninety patients admitted for LIVHR repair (defect size <15 cm) were randomized into 2 groups: nonabsorbable tacker fixation (NAT group, 45 patients) and absorbable tacker fixation (AT group, 45 patients). Intraoperative variables and postoperative outcomes were recorded and analyzed.
  
  
  RESULTS
  Patients in both the groups were comparable in terms of demographic profile and hernia characteristics. Mesh fixation time and operation time were also comparable. There was no significant difference in the incidence of immediate postoperative and chronic pain over a mean follow-up of 8.8 months. However, cost of the procedure was significantly higher in AT group (P<0.01) and NAT fixation was more cost effective as compared with AT. Postoperative quality of life outcomes and patient satisfaction scores were also comparable.
  
  
  CONCLUSIONS
  NAT is a cost-effective method of mesh fixation in patients undergoing LIVHR with comparable early and late postoperative outcomes in terms of pain, quality of life, and patient satisfaction scores.
authors.affiliation: Departments of *Surgical Disciplines †Anaesthesia ‡Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Virinder K
authors.initials: VK
authors.lastname: Bansal
authors.forename: Krishna
authors.initials: K
authors.lastname: Asuri
authors.forename: Sridhar
authors.initials: S
authors.lastname: Panaiyadiyan
authors.forename: Subodh
authors.initials: S
authors.lastname: Kumar
authors.forename: Rajeshwari
authors.initials: R
authors.lastname: Subramaniam
authors.forename: Rashmi
authors.initials: R
authors.lastname: Ramachandran
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sagar
authors.forename: Mahesh C
authors.initials: MC
authors.lastname: Misra
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D015994:Incidence; D000069290:Incisional Hernia / Q000601:surgery*; D007194:India / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D011446:Prospective Studies; D011788:Quality of Life; D013526:Surgical Mesh; D013536:Suture Techniques / Q000295:instrumentation*; D013997:Time Factors