Comparative analysis of absorbable tacker and suture techniques for peritoneal flap closure in laparoscopic inguinal hernia repair using the Transabdominal Preperitoneal (TAPP) approach: a retrospective observational cohort study

This study aims to compare the effects of peritoneal flap closure using absorbable sutures versus absorbable tackers on early postoperative pain and clinical outcomes in laparoscopic inguinal hernia repair performed with the Transabdominal Preperitoneal (TAPP) technique. This single-center retrospective study analyzed the data of 104 patients who underwent laparoscopic inguinal hernia repair using the TAPP technique between January 2022 and December 2024 and met the eligibility criteria. Patients were divided into two groups based on the peritoneal closure method: Group T (absorbable tacker, n = 55) and Group S (absorbable suture, n = 49). The primary endpoint of the study was to compare the effect of peritoneal flap closure using tackers versus sutures on the postoperative 24-hour Visual Analog Scale (VAS) pain score. Secondary endpoints included the comparison of VAS scores at other time points, postoperative complications, operation time, and the time to return to daily life/work. The postoperative 24-hour VAS scores were significantly lower in the suture group (p < 0.001). Similarly, the postoperative 6-hour and 10-day VAS scores were also lower in the suture group (p = 0.001 and p = 0.008, respectively). However, the time to return to daily life/work and the 3-month VAS scores were comparable between the groups (p = 0.253 and p = 0.085, respectively). The operation time was significantly longer in the suture group (p = 0.011). The overall complication rates were similar between the groups (p = 0.056). In TAPP repair, closure of the peritoneal flap with sutures is associated with slightly longer operative times but results in less early postoperative pain. Suture closure of the peritoneal flap may be considered a safer and more effective alternative compared to closure with absorbable tackers. However, multicenter, prospective, randomized studies are needed to validate these findings.