Skip to main content
Top
Published in: BMC Surgery 1/2022

Open Access 01-12-2022 | Seroma | Research

Effect of complete reduction of hernia sac and transection of hernia sac during laparoscopic indirect inguinal hernia repair on seroma

Authors: Chunpeng Pan, Xin Xu, Xianke Si, Jiwei Yu

Published in: BMC Surgery | Issue 1/2022

Login to get access

Abstract

Introduction

This study investigated the effect of complete reduction and transection of the hernia sac during laparoscopic indirect inguinal hernia repair on seroma.

Methods

Retrospective analysis was performed on 1763 cases undergoing laparoscopic indirect inguinal hernia repair in three centers from January 2017 to September 2019, among them, 311 patients with transection of hernia sac and 1452 patients with reduction of hernia sac, the data of the two groups were tested by t-test. Logistic univariate analysis was performed on 233 cases of postoperative seroma, and variables p < 0.05 in univariate analysis were included for multivariate analysis. Then, the transection group and the reduction group were matched with 1:1 propensity score matching, and the caliper value was set at 0.05. Finally, 274 patients matched in each group were analyzed by univariate analysis again to evaluate whether the transection of hernia sac had an impact on postoperative seroma.

Results

The results of univariate analysis of 233 patients with postoperative seroma showed that: ASA-3 p = 0.031, classification-L3 p < 0.001, surgery-TEP p < 0.001, transect group p = 0.005. The results of multivariate analysis show that: ASA-3 p < 0.001, classification-L3 p < 0.001, surgery-TEP p < 0.001, transect group p = 0.020. The results of univariate analysis after propensity score matching showed that transection of the hernia sac is significant for postoperative seroma (p < 0.001).

Conclusion

Transection of the hernia sac during laparoscopic indirect inguinal hernia repair can significantly lead to postoperative seroma.
Appendix
Available only for authorised users
Literature
1.
go back to reference Enocson A, et al. Dislocation of hemiarthroplasty after femoral neck fracture: better outcome after the anterolateral approach in a prospective cohort study on 739 consecutive hips. Acta Orthop. 2008;79(2):211–7.CrossRef Enocson A, et al. Dislocation of hemiarthroplasty after femoral neck fracture: better outcome after the anterolateral approach in a prospective cohort study on 739 consecutive hips. Acta Orthop. 2008;79(2):211–7.CrossRef
2.
go back to reference Rosen MJ, et al. Multicenter, prospective, longitudinal study of the recurrence, surgical site infection, and quality of life after contaminated ventral hernia repair using biosynthetic absorbable mesh: the COBRA study. Ann Surg. 2017;265(1):205–11.CrossRef Rosen MJ, et al. Multicenter, prospective, longitudinal study of the recurrence, surgical site infection, and quality of life after contaminated ventral hernia repair using biosynthetic absorbable mesh: the COBRA study. Ann Surg. 2017;265(1):205–11.CrossRef
3.
go back to reference Sun J, et al. Laparoscopic experience for recurrent inguinal hernia repair in a single center for 14 years. Am Surg. 2018;84(3):344–50.CrossRef Sun J, et al. Laparoscopic experience for recurrent inguinal hernia repair in a single center for 14 years. Am Surg. 2018;84(3):344–50.CrossRef
4.
go back to reference HerniaSurge G. International guidelines for groin hernia management. Hernia. 2018;22(1):1–165.CrossRef HerniaSurge G. International guidelines for groin hernia management. Hernia. 2018;22(1):1–165.CrossRef
5.
go back to reference Kockerling F. Antibiotic prophylaxis in laparoendoscopic hernia surgery. Int J Abdom Wall Hernia Surg. 2018;1(1):9–12.CrossRef Kockerling F. Antibiotic prophylaxis in laparoendoscopic hernia surgery. Int J Abdom Wall Hernia Surg. 2018;1(1):9–12.CrossRef
6.
go back to reference Gong K, et al. Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial. Surg Endosc. 2011;25(1):234–9.CrossRef Gong K, et al. Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial. Surg Endosc. 2011;25(1):234–9.CrossRef
7.
go back to reference Li J, Zhang W. Closure of a direct inguinal hernia defect in laparoscopic repair with barbed suture: a simple method to prevent seroma formation? Surg Endosc. 2018;32(2):1082–6.CrossRef Li J, Zhang W. Closure of a direct inguinal hernia defect in laparoscopic repair with barbed suture: a simple method to prevent seroma formation? Surg Endosc. 2018;32(2):1082–6.CrossRef
8.
go back to reference Dallas KB, et al. Laparoscopic versus open inguinal hernia repair in octogenarians: a follow-up study. Geriatr Gerontol Int. 2013;13(2):329–33.CrossRef Dallas KB, et al. Laparoscopic versus open inguinal hernia repair in octogenarians: a follow-up study. Geriatr Gerontol Int. 2013;13(2):329–33.CrossRef
9.
go back to reference Scheuermann U, et al. Transabdominal preperitoneal (TAPP) versus Lichtenstein operation for primary inguinal hernia repair—a systematic review and meta-analysis of randomized controlled trials. BMC Surg. 2017;17(1):55.CrossRef Scheuermann U, et al. Transabdominal preperitoneal (TAPP) versus Lichtenstein operation for primary inguinal hernia repair—a systematic review and meta-analysis of randomized controlled trials. BMC Surg. 2017;17(1):55.CrossRef
10.
go back to reference Dhankhar DS, et al. Totally extraperitoneal repair under general anesthesia versus Lichtenstein repair under local anesthesia for unilateral inguinal hernia: a prospective randomized controlled trial. Surg Endosc. 2014;28(3):996–1002.CrossRef Dhankhar DS, et al. Totally extraperitoneal repair under general anesthesia versus Lichtenstein repair under local anesthesia for unilateral inguinal hernia: a prospective randomized controlled trial. Surg Endosc. 2014;28(3):996–1002.CrossRef
11.
go back to reference Rajapaksha K. Local anesthesia for open mesh repair of recurrences after previous total extraperitoneal inguinal hernia repair. Int J Abdom Wall Hernia Surg. 2019;2(1):12–5.CrossRef Rajapaksha K. Local anesthesia for open mesh repair of recurrences after previous total extraperitoneal inguinal hernia repair. Int J Abdom Wall Hernia Surg. 2019;2(1):12–5.CrossRef
12.
go back to reference Tai HC, et al. A comparative study of standard versus laparoendoscopic single-site surgery (LESS) totally extraperitoneal (TEP) inguinal hernia repair. Surg Endosc. 2011;25(9):2879–83.CrossRef Tai HC, et al. A comparative study of standard versus laparoendoscopic single-site surgery (LESS) totally extraperitoneal (TEP) inguinal hernia repair. Surg Endosc. 2011;25(9):2879–83.CrossRef
13.
go back to reference Misra MC, et al. Massive scrotal hernias: problems and solutions. J Laparoendosc Adv Surg Tech A. 2009;19(1):19–22.CrossRef Misra MC, et al. Massive scrotal hernias: problems and solutions. J Laparoendosc Adv Surg Tech A. 2009;19(1):19–22.CrossRef
14.
go back to reference Zhang H, et al. Totally extraperitoneal laparoscopic hernioplasty: the optimal surgical approach. Surg Laparosc Endosc Percutan Tech. 2009;19(6):501–5.CrossRef Zhang H, et al. Totally extraperitoneal laparoscopic hernioplasty: the optimal surgical approach. Surg Laparosc Endosc Percutan Tech. 2009;19(6):501–5.CrossRef
15.
go back to reference Varnell B, et al. Morbidity associated with laparoscopic repair of suprapubic hernias. Am J Surg. 2008;196(6):983–7; discussion 977-8.CrossRef Varnell B, et al. Morbidity associated with laparoscopic repair of suprapubic hernias. Am J Surg. 2008;196(6):983–7; discussion 977-8.CrossRef
16.
go back to reference Powell BS, et al. Primary prevascular and retropsoas hernias: incidence of rare abdominal wall hernias. Hernia. 2015;19(3):513–6.CrossRef Powell BS, et al. Primary prevascular and retropsoas hernias: incidence of rare abdominal wall hernias. Hernia. 2015;19(3):513–6.CrossRef
17.
go back to reference Cihan A, et al. Fade or fate. Seroma in laparoscopic inguinal hernia repair. Surg Endosc. 2006;20(2):325–8.CrossRef Cihan A, et al. Fade or fate. Seroma in laparoscopic inguinal hernia repair. Surg Endosc. 2006;20(2):325–8.CrossRef
18.
go back to reference Bittner R, et al. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc. 2015;29(2):289–321.CrossRef Bittner R, et al. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc. 2015;29(2):289–321.CrossRef
19.
go back to reference Ruze R, et al. Correlation between laparoscopic transection of an indirect inguinal hernial sac and postoperative seroma formation: a prospective randomized controlled study. Surg Endosc. 2019;33(4):1147–54.CrossRef Ruze R, et al. Correlation between laparoscopic transection of an indirect inguinal hernial sac and postoperative seroma formation: a prospective randomized controlled study. Surg Endosc. 2019;33(4):1147–54.CrossRef
20.
go back to reference Rankin A, Kostusiak M, Sokker A. Spigelian hernia: case series and review of the literature. Visc Med. 2019;35(2):133–6.CrossRef Rankin A, Kostusiak M, Sokker A. Spigelian hernia: case series and review of the literature. Visc Med. 2019;35(2):133–6.CrossRef
21.
go back to reference Schmidt L, et al. Surgical techniques and convalescence recommendations vary greatly in laparoscopic groin hernia repair: a nationwide survey among experienced hernia surgeons. Surg Endosc. 2019;33(7):2235–41.CrossRef Schmidt L, et al. Surgical techniques and convalescence recommendations vary greatly in laparoscopic groin hernia repair: a nationwide survey among experienced hernia surgeons. Surg Endosc. 2019;33(7):2235–41.CrossRef
22.
go back to reference Li B, et al. Internal ring defect closure technique in laparoscopic mesh hernioplasty for indirect inguinal hernia. Front Surg. 2022;9: 794420.CrossRef Li B, et al. Internal ring defect closure technique in laparoscopic mesh hernioplasty for indirect inguinal hernia. Front Surg. 2022;9: 794420.CrossRef
23.
go back to reference Muysoms F, et al. EuraHS: the development of an international online platform for registration and outcome measurement of ventral abdominal wall hernia repair. Hernia. 2012;16(3):239–50.CrossRef Muysoms F, et al. EuraHS: the development of an international online platform for registration and outcome measurement of ventral abdominal wall hernia repair. Hernia. 2012;16(3):239–50.CrossRef
24.
go back to reference Kockerling F, et al. TEP versus TAPP: comparison of the perioperative outcome in 17,587 patients with a primary unilateral inguinal hernia. Surg Endosc. 2015;29(12):3750–60.CrossRef Kockerling F, et al. TEP versus TAPP: comparison of the perioperative outcome in 17,587 patients with a primary unilateral inguinal hernia. Surg Endosc. 2015;29(12):3750–60.CrossRef
25.
go back to reference Fan JKM, et al. Reply to comment to: preperitoneal closed-system suction drainage after totally extraperitoneal hernioplasty in the prevention of early seroma formation: a prospective double-blind randomized controlled trial. Hernia. 2018;22(3):469–70.CrossRef Fan JKM, et al. Reply to comment to: preperitoneal closed-system suction drainage after totally extraperitoneal hernioplasty in the prevention of early seroma formation: a prospective double-blind randomized controlled trial. Hernia. 2018;22(3):469–70.CrossRef
26.
go back to reference Ismail M, et al. Impact of closed-suction drain in preperitoneal space on the incidence of seroma formation after laparoscopic total extraperitoneal inguinal hernia repair. Surg Laparosc Endosc Percutan Tech. 2009;19(3):263–6.CrossRef Ismail M, et al. Impact of closed-suction drain in preperitoneal space on the incidence of seroma formation after laparoscopic total extraperitoneal inguinal hernia repair. Surg Laparosc Endosc Percutan Tech. 2009;19(3):263–6.CrossRef
27.
go back to reference Berney CR. The Endoloop technique for the primary closure of direct inguinal hernia defect during the endoscopic totally extraperitoneal approach. Hernia. 2012;16(3):301–5.CrossRef Berney CR. The Endoloop technique for the primary closure of direct inguinal hernia defect during the endoscopic totally extraperitoneal approach. Hernia. 2012;16(3):301–5.CrossRef
28.
go back to reference Aravind B, Cook A. Intra-abdominal giant infected seroma following laparoscopic inguinal hernia repair. Hernia. 2015;19(5):795–7.CrossRef Aravind B, Cook A. Intra-abdominal giant infected seroma following laparoscopic inguinal hernia repair. Hernia. 2015;19(5):795–7.CrossRef
29.
go back to reference Janis JE, Khansa L, Khansa I. Strategies for postoperative seroma prevention: a systematic review. Plast Reconstr Surg. 2016;138(1):240–52.CrossRef Janis JE, Khansa L, Khansa I. Strategies for postoperative seroma prevention: a systematic review. Plast Reconstr Surg. 2016;138(1):240–52.CrossRef
30.
go back to reference Elango S, et al. Mesh materials and hernia repair. Biomedicine (Taipei). 2017;7(3):16.CrossRef Elango S, et al. Mesh materials and hernia repair. Biomedicine (Taipei). 2017;7(3):16.CrossRef
31.
go back to reference Papageorge CM, et al. Primary fascial closure during laparoscopic ventral hernia repair does not reduce 30-day wound complications. Surg Endosc. 2017;31(11):4551–7.CrossRef Papageorge CM, et al. Primary fascial closure during laparoscopic ventral hernia repair does not reduce 30-day wound complications. Surg Endosc. 2017;31(11):4551–7.CrossRef
32.
go back to reference Othman I, Hady HA. Hernia sac of indirect inguinal hernia: invagination, excision, or ligation? Hernia. 2014;18(2):199–204.CrossRef Othman I, Hady HA. Hernia sac of indirect inguinal hernia: invagination, excision, or ligation? Hernia. 2014;18(2):199–204.CrossRef
33.
go back to reference Li J, et al. The management of indirect inguinal hernia sac in laparoscopic inguinal hernia repair: a systemic review of literature. Surg Laparosc Endosc Percutan Tech. 2021;31(5):645–53.CrossRef Li J, et al. The management of indirect inguinal hernia sac in laparoscopic inguinal hernia repair: a systemic review of literature. Surg Laparosc Endosc Percutan Tech. 2021;31(5):645–53.CrossRef
34.
go back to reference Krishna A, et al. Laparoscopic inguinal hernia repair: transabdominal preperitoneal (TAPP) versus totally extraperitoneal (TEP) approach: a prospective randomized controlled trial. Surg Endosc. 2012;26(3):639–49.CrossRef Krishna A, et al. Laparoscopic inguinal hernia repair: transabdominal preperitoneal (TAPP) versus totally extraperitoneal (TEP) approach: a prospective randomized controlled trial. Surg Endosc. 2012;26(3):639–49.CrossRef
Metadata
Title
Effect of complete reduction of hernia sac and transection of hernia sac during laparoscopic indirect inguinal hernia repair on seroma
Authors
Chunpeng Pan
Xin Xu
Xianke Si
Jiwei Yu
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-022-01599-8

Other articles of this Issue 1/2022

BMC Surgery 1/2022 Go to the issue