Transadominal suture technique in closing pseudohernia sac of direct hernia for seroma prevention after laparoscopic direct inguinal hernia repair

Abstract

Objective To investigate the efficacy of transadominal suture technique with a needle forcep in close of the pseudohernia sac of direct hernia for the prevention of seroma formation under laparoscopic direct inguinal hernia repair. Methods 74 patients with direct hernia (12 cases of type Ⅰ, 37 cases of type Ⅱ, 25 cases of type Ⅲ) were treated surgically fom January 1, 2017 to June 30, 2018. The pseudohernia sac was managed by transadominal suture technique in 62 cases of type II and type III during operation. Results All patients underwent surgery successfully. For type I hernia, the operation time was (38.42±2.81) minutes, the bleeding volume was (4.42±2.31) ml, the postoperative pain score was (2.83±1.19) at 1st day, and (1.00±0.85) at 7th day; For type Ⅱ, (44.49±3.25) minutes, (7.00±1.75) ml, (2.84±1.21) at 1st day, and (1.08±0.83) at 7th day; For type Ⅲ, (50.64±3.35) minutes, (5.92±2.60) ml, (2.84±1.18) at 1st day, and (0.92±0.86) at 7th day. There was no seroma formation, testicular swelling and pain, sexual disturbanceand, hernia recurrence and chornic groin pain after operation and during follow-up. Conclusion The management of pseudohernia sac of direct hernia with transadominal suture technique during laparoscopic direct inguinal hernia repair is safe, efficient and reliable for prevention of post-operative seroma formation, without increasing hernia recurrence and the risk of developing chronic groin pain, which is worth of being generalized. Key words: Inguinal hernia; Laparoscopes; Direct hernia; Seroma