World Journal of Laparoscopic Surgery

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VOLUME 16 , ISSUE 3 ( September-December, 2023 ) > List of Articles

Original Article

Primary Closure of Direct Inguinal Hernia Defect in Laparoscopic Repair by Pre-tied Suture Loop Technique for Prevention of Seroma: A Prospective Cohort Study

Sachin S Singh, Ajay M Rajyaguru

Keywords : Laproscopy, Pseudosac, Pretied suture loop (endoloop), Seroma, Transabdominal preperitoneal meshplasty, Transversalis fascia

Citation Information : Singh SS, Rajyaguru AM. Primary Closure of Direct Inguinal Hernia Defect in Laparoscopic Repair by Pre-tied Suture Loop Technique for Prevention of Seroma: A Prospective Cohort Study. World J Lap Surg 2023; 16 (3):166-168.

DOI: 10.5005/jp-journals-10033-1587

License: CC BY-NC 4.0

Published Online: 12-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Aims and background: Postoperative seroma is a common complication of laparoscopic mesh repair of direct inguinal hernia. Several kinds of attempts have been made to reduce its incidence though they are not without problems. The aim of this study was to evaluate the efficiency of a new alternate technique that must be safe and with fewer complications, using a widely available and inexpensive pre-tied suture loop (endoloop) for plication of the weakened transversalis fascia (TF)/pseudosac. Materials and methods: A prospective cohort study of 47 patients diagnosed with a total of 63 direct inguinal hernias during a 57-month period fit for laparoscopic tranabdominal preperitoneal (TAPP) meshplasty. Each of the M2 or M3 direct defects, according to the European Hernia Society (EHS), was systematically repaired by TAPP using pre-tied suture loop application at the base of TF. Patients were reviewed during follow-up at 2, 6 weeks, and 1 year after the operation to look for primary postoperative outcome parameters, i.e., seroma formation; secondary outcome parameters, i.e., groin pain, wound infection, and recurrence. Results: During the follow-up period, no patient presented with seroma formation and wound infection. Only two patients had complaints of groin pain at 2-week follow which was resolved by analgesics and there was no hernia recurrence after a follow-up of 1 year. Conclusion: Application of a pretied suture loop at the base of TF during laparoscopic repair of direct inguinal hernia is cost effective, safe method and does not increase the risk of seroma formation and recurrence. Clinical significance: Seroma formation is a major concern for surgeons as well as patients during postoperative period following laparoscopic inguinal hernia repair. The development of a cost-effective, reliable technique with the least or no seroma formation and recurrence prevention is needed at this time.

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