V-040 Primary Abandon-of-the-Sac: A Case Report

Abstract

Background Inguinal hernia repair is one of the most frequent surgical procedures worldwide. Several minimally invasive approaches have been developed. Laparoscopic hernioplasty offers less pain, faster recovery and a lower incidence of wound infection. However, the best approach in repairing large inguinoscrotal hernias and the optimal management of the distal sac and its risks are still debated. There may be a higher risk of visceral or cord structures damage, ischemic orchitis, seroma or haematoma when opting for a complete dissection of the hernia sac which may extend deep into the scrotum. Objective To show a video of a transabdominal preperitoneal (TAPP) approach using the primary abandon of the sac technique. The aim of this is to reduce the complications above-stated. Method We report a case of a 33 year old man, without previous abdominal surgery, diagnosed with a large right inguinoscrotal hernia, which appeared 1 year ago and became painful. The patient was scheduled electively for a TAPP surgery. Results Surgery was performed by means of day surgery. No intraoperative complications. No seroma nor haematoma detected in the postoperative period. Conclusion Laparoscopic best approach of repairing inguinoscrotal hernias are still debatable. The primary abandon of the sac is a feasible and reproducible technique and is a safe manner to overcome the difficulties of the distal sac management.