Background: Many ventral hernia
repair methods have been described among surgeons. The traditional primary
repair entails a laparotomy with suture approximation of strong fascial tissue
on each side of the defect. However, recurrence rates after this procedure
range from 12% to 24% during long-term follow-up. Laparoscopic ventral hernia
repair (LVHR) is a well recognized minimally invasive surgical technique for
repair of different types of abdominal wall ventral hernias. However, the best
method of mesh fixation during LVHR is still a subject ofdebate. Patients
& Methods: In the present study, 50 patients were presented with ventral
hernia between June 2012 and October 2013. Demographics of the patients were
recorded. All patients were submitted to LVHR with mesh fixation by “Double
Crown” of tackers. The first crown was placed on the mesh periphery with 1 cm
between each 2 successive tackers and the second crown around the edges of the
defect. Operative complications, VAS scale, post-operative complications, and
length of hospital stay were reported. Results: The mean age was 40.08 years.
Female to male ratio was 3:2. The mean BMI was 32.3. The diameter of the
hernial defect was <5 cm in 64%, while, the defects larger than 15 cm were
excluded. LVHR was successfully completed in all the patients with no
conversion. Only 1 patient had intra-operative bleeding from omental vessels
that was successfully controlled. The mean operative time was 79 minutes.
Post-operatively, the mean VAS was 3.96, 2.12, and 0.24 at 24 hours, 2 weeks,
and 4 weeks, respectively. Two patients developed post-operative ileus that was
treated conservatively and 1 patient developed persistent seroma that was
treated by repeated aspiration. The mean length of hospital stay was 3.08 days.
Conclusion: “Double Crown” tackers mesh fixation in LVHR seems to be a safe and
effective surgical technique with favorable outcome. However, further randomized
studies are needed on larger numbers of patients to validate these results.