We investigated if a novel fixation device with absorbable tacks (Securestrap) causes less early and chronic postoperative pain after laparoscopic repair with a double-crown mesh fixation of ventral abdominal wall hernia when compared with the standard fixation device with nonabsorbable titanium tacks (Protack). The primary outcome measure was early postoperative pain at 2, 6, and 12 weeks postoperatively. The secondary outcome measure was chronic postoperative pain measured ≥18 months after surgery. Pain levels were assessed using a visual analog scale ranging from 0 (no pain) to 100 mm (excruciating pain). Early postoperative pain was significantly lower in group 2 (absorbable tacks) at 6 (2 vs. 5; P=0.008) and 12 weeks (1 vs. 2; P=0.008) but not at follow-up (6 vs. 11; P=0.21). Given the very low visual analog scale scores in both groups, the clinical significance of these finding remains open to discussion.

Colonoscopy is a common and increasingly performed procedure. It is used both as a diagnostic and therapeutic modality. Splenic injury after colonoscopy is a rare, yet life-threatening complication, most often caused by traction on the splenocolic ligament or excessive manipulation during the procedure. Although non-operative treatment is preferred upon splenic injury, early surgical or radiological intervention may be necessary in specific cases, for example in case of haemodynamic instability. A 71-year-old Caucasian man was referred to our emergency room due to shock after colonoscopy 2 days earlier. A computed tomography scan showed splenic rupture with active intra-abdominal, venous blood loss, and microperforation of the colon. An immediate splenectomy and colon repair were performed through laparotomy. After 6 days, the patient was discharged from hospital in good health. Although splenic rupture is a rare complication of colonoscopy, patients with abdominal pain and/or shock should be checked for complications such as splenic injury and colon perforation.