Introduction: Pain outcome post-Laparoscopic Ventral and Incisional Hernia Repair (LVIHR) has been largely attributed to the technique of mesh fixation.  This study primarily aims to compare early postoperative pain and surgical outcomes with two fixation methods [absorbable tacks (AT) and non-absorbable tacks (NAT)], and two different types of meshes. 
Methods: This is a retrospective study of patients who underwent LVIHR between September 2011 and August 2016. The groups of mesh and fixation were compared with respect to early postoperative pain scores using Visual Analogue Score (VAS 0-10) and incidence of seroma, wound infection, and recurrence rates.
Results: Fifty-six patients with LVIHR were enrolled (41 in AT and 15 in NAT group), PhysioMesh™ was used in 14 and Proceed™ mesh in 42 patients. Mean VAS was significantly higher in the AT as compared to NAT group at first 6 hours after operation (p=0.02), first 24 hours (p=0.04), day 2 (p=0.02), however, it was similar after 48 hours (p=0.2) and at 4 weeks postoperatively (0.8). There were no significant differences in postoperative pain between mesh groups. The fixation method had no effect on the incidence of seroma, wound infection and recurrence rate. However, seroma (p=0.02), wound infection (p=0.01) and hernia recurrence (p=0.01) were higher in PhysioMesh™ as compared to Proceed mesh group independent from methods of mesh fixation. 
Conclusion: AT mesh fixation was associated with higher postoperative pain intensity compared to NAT during the early postoperative period independent of mesh type, however, it was similar at 4 weeks.  PhysioMesh™ was associated with higher recurrence rate, seroma and wound infection compared to Proceed mesh.

Early Pain and Surgical outcomes post laparoscopic ventral and incisional hernia repair.