Impact of Closed-suction Drain in Preperitoneal Space on the Incidence of Seroma Formation After Laparoscopic Total Extraperitoneal Inguinal Hernia Repair
“…Seroma is a common post-LIHR complication, which has an incidence between 1.9% and 22.9%. 10 This complication is mainly caused by the secretions of the excluded distal hernia sac after hernia sac transection or the residual accumulated liquid in the empty cavity after hernia content reduction. Seroma has a high incidence among patients with a long-term adhesive hernia sac as well as with a large scrotal hernia.…”
LIHR is a safe and feasible procedure. It has significantly better effects on postoperative pains and hernia relapse than Lichtenstein tension-free hernia repair.
“…Seroma is a common post-LIHR complication, which has an incidence between 1.9% and 22.9%. 10 This complication is mainly caused by the secretions of the excluded distal hernia sac after hernia sac transection or the residual accumulated liquid in the empty cavity after hernia content reduction. Seroma has a high incidence among patients with a long-term adhesive hernia sac as well as with a large scrotal hernia.…”
LIHR is a safe and feasible procedure. It has significantly better effects on postoperative pains and hernia relapse than Lichtenstein tension-free hernia repair.
“…The drain was also placed in patients on antiplatelet therapy. Some previous studies have demonstrated that use of closed suction drainage in TEP hernia repair led to a significant decrease in seroma formation without any increase in the risk of infection or recurrence [29].…”
There was no significant difference between fixation and nonfixation of mesh in TEP inguinal hernia repair with respect to postoperative pain, length of hospital stay, resumption of normal activities, seroma formation, and recurrence rate. Nonfixation of mesh is safe and recommended in TEP inguinal hernia repair when done by an experienced surgeon, even in a rural setting. The study highlights the potential for universal application of the procedure.
“…Attempts to reduce the occurrence of seroma formation have included closed suction drainage of the preperitoneal space [3] or tacking the loose TF to the pubic ramus [4]. Both of these techniques are not without problems, as they can create extra discomfort to the patient, potentially increase the risk of infection, and also lead to chronic pubic bone pain from the tack staples or vasculo-nervous injury if Wxing the TF to the abdominal wall.…”
The primary closure of direct inguinal hernia defects with a pre-tied suture loop during endoscopic TEP repair is safe, efficient, and very reliable for the prevention of post-operative seroma formation, without increasing the risk of developing chronic groin pain or hernia recurrence. This technique should be the preferred method over stapling of the TF or the insertion of a closed suction drainage device in such a situation.
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