Comparison of Suture versus Tacker Techniques for Peritoneal Closure in Laparoscopic TAPP Inguinal Hernia Repair: A Randomized Controlled Trial

Abstract

Background: Peritoneal closure is a critical step in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. Various techniques are used, most commonly intracorporeal suturing and mechanical fixation using tackers. However, the optimal method remains controversial, particularly with respect to postoperative pain, complications, operative time, and cost.

Objective: To compare postoperative pain, complications, and duration of surgery between suture and tacker techniques for peritoneal closure in laparoscopic TAPP inguinal hernia repair.

Methods: This randomized controlled trial was conducted in the Department of General Surgery, Nishtar Hospital, Multan, over six months, from March 2025 to September 2025. A total of 96 male patients undergoing elective laparoscopic TAPP repair were randomly allocated into two groups: Group A (peritoneal closure with sutures) and Group B (peritoneal closure with tackers). Postoperative pain was assessed using the Visual Analogue Scale (VAS). Complications and operative time were recorded and analyzed using SPSS version 23.

Results: Patients in the suture group experienced significantly lower postoperative pain compared to the tacker group (p < 0.05). The incidence of postoperative complications was also lower in the suture group, while the mean operative time was slightly longer but not statistically significant.

Conclusion: Intracorporeal suturing for peritoneal closure in TAPP repair is associated with reduced postoperative pain and fewer complications compared to tacker fixation, making it a safer and more cost-effective option in experienced hands.