• Jason Joe Baker, Stina Öberg, Kristoffer Andresen, Frederik Helgstrand, and Jacob Rosenberg.
• Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark. jason_baker9@hotmail.com.
• Langenbecks Arch Surg. 2018 Jun 1; 403 (4): 521-527.

BackgroundThere are various ways of fixating an intraperitoneal onlay mesh during a laparoscopic ventral hernia repair. The risk of complications is high, and around 22% of the hernias will recur within 3.5 years. The aim of this study was to assess if sutures in addition to tack fixation would reduce the re-operation rate for recurrence compared with permanent tacks without sutures.MethodsThis study was based on the data from the nationwide Danish Ventral Hernia Database, which contains information of ventral hernia repairs from all hospitals in Denmark. Two different cohorts of patients were created and analyzed separately. The primary outcome was the re-operation rate for recurrence, analyzed with the Cox regression model and illustrated with a Kaplan-Meier plot adjusted for confounders. The follow-up period was defined as months from the first hernia repair to re-operation for recurrence, death, or the 1st of June 2017.ResultsThe first cohort included 598 patients with absorbable sutures and tacks compared with 1793 patients with permanent tacks. The second cohort included 72 patients with permanent sutures and tacks compared with 216 patients with permanent tacks. In the suture groups, the tack material was either permanent or absorbable. When adjusting for possible confounders in the Cox regression model, there were no significant differences in the re-operation rate for recurrence between the groups in the two cohorts.ConclusionAdding sutures, either absorbable or permanent, to tack fixation of mesh during laparoscopic ventral hernia repair did not influence the re-operation rates for recurrence.

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