ArticleFrontiers in surgery2022
Internal Ring Defect Closure Technique in Laparoscopic Mesh Hernioplasty for Indirect Inguinal Hernia.
Article in Frontiers in surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 16 citations in OpenAlex.
- Internal ring ligation in laparoscopic transabdominal preperitoneal repair of giant inguinoscrotal hernia: a non-prospective comparative study on seroma outcomes.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Different methods of managing the distal hernia sac to prevent seroma after laparoscopic repair of large indirect inguinal hernias: a real-world study.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
- Percutaneous inguinal canal semi-closure during laparoscopic repair for large indirect inguinal hernia.Surgical endoscopy · 2025Article
- Postoperative compression in preventing early complications after groin hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2023Observational
- Clinical efficacy of laparoscopic closed hernia ring combined with a patch repair for Gilbert type III indirect inguinal hernia.Frontiers in surgery · 2023Article
- Comment to: feasibility of modified‑TEP technique for large inguinoscrotal and large femoral hernia and its advantages.Hernia : the journal of hernias and abdominal wall surgery · 2022Article
- Effect of complete reduction of hernia sac and transection of hernia sac during laparoscopic indirect inguinal hernia repair on seroma.BMC surgery · 2022Article
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Authors and funding
10 authors at 4 institutions in 1 country.
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Abstract
purposeThe best way to reduce seroma formation after laparoscopic indirect hernia repair is debated. We noticed that internal ring defect closure in laparoscopic mesh hernioplasty could provide promising outcomes with an effect on diminishing seroma formation. We introduce our closure technique and report our experience.
methodsThis prospective study was conducted from May 2019 to May 2021. Patients with European Hernia Society classification L3 indirect or scrotal hernia were recruited and underwent laparoscopic transabdominal patch plasty (TAPP). Hernia defect closure was performed before mesh deployment. The primary outcomes were seroma formation, postoperative pain, and hernia recurrence. Perioperative data and postoperative complications were also recorded.
resultsConsecutive 77 patients with 89 indirect hernias (including 51 scrotal hernias) were recruited in two regional tertiary hospitals. All operations were successful without open conversion. The mean size of the hernia defect was 3.7 ± 0.5 cm (range, 2.5-5.0 cm). The mean operative time for each hernia repair (peritoneum to peritoneum) was 48.3 ± 10.8 min (range, 33-72 min), and the mean time required for internal ring closure was 6.7 ± 2.2 min (range, 4-10 min). Intraoperative bleeding was minimal. The mean visual analog scale pain score at rest on the first postoperative day was 2.2 (range, 1-4). The average postoperative length of hospital stay was 18 h (range, 14-46 h). During a mean follow-up period of 9.4 months (range, 3-23 months), no hernia recurrence or chronic pain were noted. Seroma formation was detected on six sides of unilateral hernias (6.7%) on postoperative day 7, with a mean volume of 45.8 ml (range, 24-80 ml). All seromas were mild and resolved spontaneously within 3 months, with no need for evacuation or other treatment and without major impact on the final outcome.
conclusionsDefect closure in laparoscopic mesh hernioplasty for large indirect hernias is safe and feasible and can significantly reduce postoperative seroma formation and relative complications. This approach is recommended in large indirect or scrotal hernia repair.
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