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WJOLS

Comparative Study of Tacker vs Glue Fixation of Mesh in Laparoscopic Intraperitoneal
There were no intraoperative and postoperative Table 2: Length of Hospital Stay
complications with glue fixation. Glue Tacker
In tacker fixation, seroma was seen in 4 cases Mean SD Mean SD
(13.33%), hematoma in 1 (3%), bowel ileus in 1 (3%), 2.07 0.25 3.00 0
whereas intra-abdominal complications, bowel obstruc- SD: Standard deviation
tion, bleeding from trocar site, and enterocutaneous
fistula were 0 (0%). The glue fixation group did have a
lesser complication rate 0/30 (0%) as compared with 6/30
(20%) in tacker group.
Pain is a reliable criterion in the assessment of
any ventral hernia repair, due to the extent of dissec-
tion involved. The postoperative pain was recorded at
24 hours, 48 hours, and 1 month after operation by using
VAS pain scoring system. The mean pain score of glue
fixation and tacker fixation at 24 hours was 1 and 2.23
respectively (p = 0.00) (Table 1 and Graph 1).
Median (range) postoperative hospital stay for
patients with tacker fixation is 3 (2–4) days, which is more
as compared with 2 (1–3) days in glue fixation, which is
statistically significant (p < 0.0001) (Table 2 and Graph 2).
Patients with tacker fixation took more time to return to Graph 2: Length of hospital stay in tracker vs glue fixation
normal activities like ambulation, personal dressing, and
toilet use, with mean of 3 ± 0.6 days as compared with 1 ± DISCUSSION
0.58 days in glue fixation group, which is statistically
significant (p < 0.005). Treatment for hernia is surgical repair, which has evolved
Cost of glue fixation is 50% less as compared with continuously over several centuries. The concept of
tacker fixation owing to the added cost of tacker. minimally invasive surgery has changed many aspects in
the surgical care of the patients, regardless of the access
techniques employed for a given patient. Most of the ben-
Table 1: Comparison of pain efits are centered on improvements in the postoperative
Groups recovery period, including a shorter length of hospital
Glue Tacker stay and earlier return to normal activities. Recently, there
VAS score Mean SD Mean SD has been an increasing demand for laparoscopic repair
At 24 hours 1.00 0.45 2.23 1.14
At day 2 0.13 0.35 1.10 0.31 from the patient population, and it has also become part
At 1 month 0 0 0 0 of the surgeon’s choice.
SD: Standard deviation The aim of this study is to apply to hernia surgery
the advantages of laparoscopy: Less trauma, lesser
postoperative pain, early discharge, and early renewal
1
of the normal activity. Chevrel and Rath first proposed
fibrin sealant as an alternative means of mesh fixation
in hernia repair.
In our study, the average operation time in tacker
fixation as compared with glue fixation is lesser in our
study, which is again comparable to the study of Eriksen
2
et al, which shows glue fixation took longer than tacker
fixation.
The mean pain score of glue fixation and tacker
fixation at 24 hours was 1 and 2.23 respectively (p = 0.00).
3,4
Olmi et al from Zingonia, Italy, evaluated the efficacy
and acceptability of glue in small- to medium-sized
ventral hernias. In two clinical studies, they detected
stable and uniform fixation of the prosthesis and
Graph 1: Comparison of pain in tracker vs glue fixation minimized intra- and postoperative complications with a
World Journal of Laparoscopic Surgery, September-December 2017;10(3):87-90 89