ABSORBABLE VERSUS NON-ABSORBABLE TACKERS IN LAPAROSCOPIC HERNIA REPAIR: A RETROSPECTIVE COMPARATIVE STUDY OF POSTOPERATIVE PAIN AND CLINICAL OUTCOMES

Abstract

Background Mesh fixation is an important component of laparoscopic hernia repair. Non-absorbable tackers provide durable mechanical fixation but remain permanently implanted and may contribute to prolonged local tissue irritation. Absorbable tackers have been developed as an alternative, with the potential to reduce persistent foreign-body reaction and fixation-related postoperative discomfort. However, comparative evidence regarding their clinical superiority remains inconclusive. Objective: To compare postoperative pain and selected clinical outcomes between absorbable and non-absorbable tackers in patients undergoing laparoscopic hernia repair. Methods: A retrospective comparative study was conducted among 50 patients undergoing laparoscopic hernia repair. Twenty-five patients underwent mesh fixation using absorbable tackers and 25 using non-absorbable tackers. The study population included patients undergoing laparoscopic repair of inguinal, umbilical and incisional hernias. Demographic variables included age, sex and body mass index (BMI). Postoperative pain was assessed at 24 hours, 7 days and 1 month. Secondary outcomes included healing time, duration of hospital stay, seroma formation, postoperative infection and hernia recurrence. Continuous variables were summarized as mean ± standard deviation and categorical variables as frequencies and percentages. Results: The mean age was 45.16 ± 8.77 years in the absorbable-tacker group and 44.76 ± 9.89 years in the non absorbable-tacker group. Mean BMI was 25.43 ± 3.26 and 25.85 ± 3.33 kg/m², respectively. The two groups were comparable with respect to age, BMI and sex. Inguinal hernia was the most common hernia type in both groups. The source study results demonstrated lower postoperative pain scores with absorbable tackers at 24 hours (4.4 ± 1.3 versus 5.6 ± 1.2), 7 days (2.3 ± 1.1 versus 3.4 ± 1.0), and 1 month (0.8 ± 0.6 versus 1.4 ± 0.7). Reported P values were 0.01, 0.02 and 0.04, respectively. Healing time and hospital stay were also reported to be lower with absorbable fixation. Seroma occurred in 12% versus 28%, while recurrence occurred in 8% versus 20% of patients in the absorbable and non-absorbable groups, respectively. These differences in seroma and recurrence were not statistically significant. Conclusion: In this retrospective cohort, absorbable tackers were associated with lower postoperative pain and shorter reported healing time and hospital stay. Although seroma and recurrence were numerically less frequent with absorbable fixation, the available evidence does not establish definitive superiority. Larger prospective studies with standardized pain assessment and adequate long-term follow-up are required.