Laparoscopic Tapp Inguinal Hernia Repair: Mesh Fixation With Absorbable Tacks, Initial Experience

Preliminary studies have indicated advantages of mesh fixation using fibrin glue in TAPP compared with tack fixation. We report the results of a prospective experience in fixing mesh during TAPP with absorbable tacks. 50 consecutive men (who had bilateral inguinal hernia) were enrolled and followed up for at least 1 year. The primary measured outcome was pain experienced in day 1 of post-op. The secondary outcomes measured were postoperative scores of pain at rest, discomfort, and fatigue, foreign-body sensation, and hernia recurrence after 12 months. The outcomes were measured using a visual analogue scale, a verbal rating scale and numerical rating scales. A comparison was done within a historical group with the same demographic and hernia characteristics where the meshes have been fixed with fibrin glue. The group of tacks ‘TAPP’ showed good results concerning the level of pain, fatigue and foreign body sensation comparable with those of the historical group. There were significant differences concerning the length of surgery where absorbable tacks performed better. Regarding cost of surgery, the fibrin glue showed effective results. The use of absorbable tacks during TAPP confers significant benefit regarding the operating time, however it is a disadvantage due to the cost when compared with fibrin glue.