Closure of peritoneal in inguinal hernia transabdominal preperitoneal by intracorporeal suturing versus tackers


  • Vinod Kumar Singhal Department of General Surgery, Prime Hospital, Dubai, UAE
  • Faris Dawood Alaswad Department of General Surgery, NMC Specialist Hospital, Dubai, UAE
  • Varsha Ojha Department of General Surgery, Prime Hospital, Dubai, UAE
  • Vidher Varsha Vinod Singhal University College London, London, United Kingdom



Inguinal hernia, Laparoscopic hernia repair, Mesh, Suture, Tacker, TAPP


Background: Hernia surgeries are among the most frequently carried out surgical procedures. Minimal recurrence rates, great patient comfort, rapid return to work, and low cost should all be characteristics of the optimal hernia treatment method. Objective of this study was to investigate whether tacker and suture materials used for peritoneal closure after mesh placement in the laparoscopic TAPP inguinal hernia repair technique.

Methods: Present study is a retrospective, observational & comparative study conducted in Department of General Surgery in a tertiary care hospital from January 2021 to December 2021. Institutional ethical committee clearance was obtained. Patient identity was kept confidential. According to the type of peritoneal closure, patients were separated into two groups: group S (which underwent closure with sutures) and group T (which received closure with tackers) 48 and 52 during the study period. SPSS was used for analysis.

Results: The study was male preponderance comprising 94% of study participants, while the most common age group was found to be 61-70 years in both groups S and T (32%). most patients in the suture fixation group (39%) had left-sided hernias, but right-sided hernias (40%) were more typical in the tacker fixation group.

Conclusions: Our research revealed no differences between the two peritoneal closure approaches in terms of VAS score at day 30, hernia recurrence rate, hospital stay, or complication rate. VAS score on day 1 and cost of operation were in favor of the suture group.



Tolver MA, Rosenberg J. Pain during sexual activity before and after laparoscopic inguinal hernia repair. Surg Endosc. 2015;29(12):3722-5.

Oguz H, Karagulle E, Turk E, Moray G. Comparison of peritoneal closure techniques in laparoscopic transabdominal preperitoneal inguinal hernia repair: a prospective randomized study. Hernia. 2015;19:879-85.

Hoseini M, Mousavie SH, Farazmand B, Jodai E, Negahi A. Comparison of peritoneum closure with suturing or tacker or using dual mesh without peritoneal closure in laparoscopic inguinal hernia repair. J Adv Pharm Edu Res. 2019;9(S2):150-3.

The Hernia Surg Group. International guidelines for groin hernia management. Hernia. 2018;22:1–165.

Sharma D, Yadav K, Hazrah P, Borgharia S, Lal R, Thomas S. Prospective randomized trial comparing laparoscopic transabdominal preperitoneal (TAPP) and laparoscopic totally extra peritoneal (TEP) approach for bilateral inguinal hernias. Int J Surg. 2015;22:110–7.

Bittner R, Leibl BJ, Jäger C, Kraft B, Ulrich M, Schwarz J. TAPP - Stuttgart technique and result of a large single center series. J Minim Access Surg. 2006;2(3):155–9.

Mayer F, Niebuhr H, Lechner M. When is mesh fixation in TAPP-repair of primary inguinal hernia repair necessary? The register-based analysis of 11, 230 cases. Surg Endosc. 2016;30:4363-71.

Bansal VK, Misra MC, Babu D, Singhal P, Rao K, Sagar R, et al. Comparison of long-term outcome and quality of life after laparoscopic repair of incisional and ventral hernias with suture fixation with and without tacks: a prospective, randomized, controlled study. Surg Endosc. 2012;26(12):3476–85.

Ross SW, Oommen B, Kim M, Walters AL, Augenstein VA, Heniford BT. Tacks, sta-ples, or suture: method of peritoneal closure in laparoscopic transabdominal preperitoneal inguinal hernia repair effects early quality of life. Surg Endos. 2015;29(7):1686-93.

Kitamura RK, Choi J, Lynn E, Divino CM. Suture versus tack fixation of mesh in laparo-scopic umbilical hernia repair. JSLS. 2013;17(4):560.

Selvakumar S, Sankar SS, Balaji P. Comparative study on suture fixation vs tacker fixation for laparoscopic inguinal hernia repair-TAPP. Global J Res Analysis. 2019;8(3):52-54.

Morrison JE Jr, Jacobs VR. Laparoscopic preperitoneal inguinal hernia repair using preformed polyester mesh without fixation: Prospective study with 1 year follow up results in a rural setting. Surg Laparosc Endosc Percutan Tech. 2008;18(1):33-9.

Lau H, Patil NG, Yuen WK, Lee F. Prevalence and severity of chronic groin pain after endoscopic totally extraperitoneal inguinal hernioplasty. Surg Endosc. 2013;17:1620 3.






Original Research Articles