Migrating Helical Tack Causing Chronic Discharging Sinus Following Laparoscopic Ventral Hernia Repair: A Case Report
Choice of prosthetic mesh and secure anchorage to its bed is key to successful laparoscopic repair of a ventral hernia. Transfascial suture and tack are two commonly used techniques for mesh fixation. While transfascial suture causes more post-operative pain, tack’s anchorage is a suspect. Spiral tacks are inert and cause less tissue reaction. Though isolated case reports are available regarding pain and intestinal complications arising from the use of tacks, the incidence of tack migration through the fascial layer and causing discharging chronic sinus mimicking mesh infection has been reported only once. Surgeons should be aware and cautious about using new technologies to provide correct management strategy in individual cases of complications arising from them, rather than treating them empirically. As complications can arise even after years of primary surgery, a longer period of follow-up is essential for comparative evaluation of different techniques.