Reloadable Fixation Device Assists Laparoscopic Hernia Repair

The ReliaTack system provides surgeons with greater access to weak spots within the abdominal wall thanks to an adjustable articulation of up to 65 degrees, enabling them to more securely place tacks perpendicular to the mesh, minimize mesh shift, and potentially eliminate contralateral ports. The system is provided with proprietary 5.1 mm long absorbable screw-like tacks constructed of poly lactic-co-glycolic acid (PLGA), an absorbable synthetic polyester copolymer that is dyed violet for enhanced visibility.

The tacks offer twice the strength staple fixation devices, and are available in interchangeable reload sets that are packaged together with the handle. The device can accommodate standard 5- or 10- PGLA tack reloads, reloaded and fired for a total of 60 tacks in a single procedure. The PGLA tacks degrade and are absorbed by hydrolysis to glycolic acid and lactic acid, which are then metabolized by the body. PGLA absorption is essentially completed prior to one year. The ReliaTack system is a product of Covidien (Dublin, Ireland), and had been approved by the US Food and Drug Administration (FDA).

“Developed with valuable input from surgeons, the ReliaTack device, combined with our recently-launched Symbotex composite mesh, benefits patients while helping drive greater operating room efficiency and economic benefits,” said Rob Claypoole, vice president and general manager of Hernia at Covidien. “The ReliaTack fixation device overcomes numerous physical and ergonomic challenges in ventral hernia repair by allowing a wide variety of angles to more effectively position and secure hernia mesh.”

Laparoscopic ventral hernia repair involves the placement of a mesh inside the abdomen, without abdominal wall reconstruction; the mesh is fixed with sutures, staples, or tacks. The recurrence rate of laparoscopic repair is reported as equal (or less) than an open approach. On the other hand, the laparoscopic approach has been criticized for not resecting the hernia sac and not restoring the anatomy, resulting in persistence of abdominal bulging and an abdominal wall that is mechanically unstable and has uncoordinated muscles. In addition, placement of a mesh over the defect leads to seroma formation in a large number of patients.

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