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Laparoscopic repair of direct inguinal hernia: a new technique that reduces the development of postoperative seroma

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Abstract

Background

Seroma are common early postoperative complications encountered in laparoscopic inguinal hernia repair. Previous anecdotal evidence from our surgical practice suggested a lower incidence of postoperative seroma formation with direct hernia repairs when the lax transversalis fascia (TF) is inverted by tacking to the pubic ramus. We undertook a study to investigate whether TF inversion in this way reduces the incidence of postoperative seroma.

Method

A total of 216 patients undergoing transabdominal preperitoneal (TAPP) laparoscopic inguinal hernia repairs from August 2003 to December 2005 were included in this prospective non-randomised controlled study. Surgeon 1 would routinely invert the TF whereas surgeon 2 would not. At follow-up the presence of postoperative seroma and pain was recorded.

Results

Mann–Whitney U test demonstrated no significant difference in terms of age, sex and time to follow-up between the surgeons’ patient groups (P > 0.05), and Chi-square test demonstrated significantly that inversion of the TF is associated with a lower incidence of postoperative seroma (P < 0.05). There was no significant difference in terms of postoperative pain at follow-up.

Conclusion

Inversion of the TF is associated with a statistically lower incidence of postoperative seroma, without increasing postoperative pain despite the use of one or two additional tacks.

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Correspondence to V. M. Reddy.

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Reddy, V.M., Sutton, C.D., Bloxham, L. et al. Laparoscopic repair of direct inguinal hernia: a new technique that reduces the development of postoperative seroma. Hernia 11, 393–396 (2007). https://doi.org/10.1007/s10029-007-0233-4

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  • DOI: https://doi.org/10.1007/s10029-007-0233-4

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