Short term results of routine defect closure and obliteration of dead space in minimal invasive inguinal hernia repairs: a retrospective cohort study.

backgroundSeroma formation and recurrence are considered two of the most common complications of inguinal hernia repair especially in minimal invasive approach especially when the defect size is large. Closure of the defect and obliteration of dead space(DCODS) can help mitigate these complications. Robotic surgery helps in closure of the defect because of the ease of suturing. The aim of this study is to evaluate the short-term results of closure of defect in these hernias.

methodsRetrospective analysis of the data of all patients who underwent total extraperitoneal (TEP)/extended Total extraperitoneal(eTEP) or robotic trans abdominal pre peritoneal (rTAPP) for inguinal hernia repairs in a single tertiary care centre was done in this cohort study. Primary outcome analysed was seroma formation, the secondary outcomes included groin pain, surgical complications, and early hernia recurrence.

resultsA total of 198 hernia repairs were carried out in 136 patients. 132 were male and 4 were female. Of these 32 patients who had undergone a Lichtenstein's repair were excluded. There were 102 rTAPP repairs and 64 TEP/eTEP repairs in all. Mean age was 49.77(SD 17.3)years and mean BMI was 27.52(SD 5.21)kg/m

conclusionDCODS significantly reduces the risk of seroma formation without increasing the post operative pain and incidence of chronic groin pain. DCODS appears to be easier with the use of robotic platform as it involves technically challenging suturing at odd angles.