Abstract
Background
Seromas after endoscopic totally extraperitoneal (TEP) inguinal hernia repair are still common to see, which could be a limiting factor that restrains the use of endoscopic TEP approach especially for complicated and severe inguinal hernia.
Methods
Retrospective researches were carried out on 478 cases of inguinal hernia who received endoscopic TEP hernia repair from March 2009 to March 2014, including 321 draining cases and 157 non-draining cases.
Results
A total incidence of seroma was observed in 8.79 % patients of 478 cases. 13 and 29 seromas occurred in draining group and non-draining group respectively (4.05 vs. 18.47 %, P < 0.05). In both general hernia group (411 cases) and giant scrotal hernia and irreducible hernia group (67 cases) 21 patients were observed formation of seroma (5.11 vs. 31.34 %, P < 0.001). Incidence of seroma in draining vs. non-draining group of general hernia was 2.87 vs. 9.85 % (P < 0.05), and that 11.90 vs. 64.00 % of giant scrotal and irreducible hernia (P < 0.001). Pain score reduced significantly in draining group one week postoperatively compared with non-draining group (P < 0.05). Incidences of hospital stay after operation, infectious complications and hernia recurrence were comparable in draining and non-draining group (P > 0.05).
Conclusions
Efficient drainage in preperitoneal space may effectively reduce the incidences of seroma after endoscopic TEP approach and it may be of vital significance especially in giant scrotal hernias and irreducible hernias.
Similar content being viewed by others
References
Feliu X, Claveria R, Besora P, Camps J, Fernandez-Sallent E, Vinas X, Abad JM (2011) Bilateral inguinal hernia repair: laparoscopic or open approach? Hernia 15(1):15–18
Goo TT, Lawenko M, Cheah WK, Tan C, Lomanto D (2010) Endoscopic total extraperitoneal repair of recurrent inguinal hernia: a 5-year review. Hernia 14(5):477–480
Feng B, He ZR, Li JW, Ling TL, Zhang Y, Chen X, Lu AG, Wang ML, Zheng MH (2013) Feasibility of incremental laparoscopic inguinal hernia repair development in China: an 11-year experience. J Am Coll Surg 216(2):258–265
Mainik F, Flade-Kuthe R, Kuthe A (2005) Total extraperitoneal endoscopic hernioplasty (TEP) in the treatment of incarcerated and irreponible inguinal and femoral hernias. Zentralbl Chir 130(6):550–553
Tai HC, Lin CD, Chung SD, Chueh SC, Tsai YC, Yang SS (2011) A comparative study of standard versus laparoendoscopic single-site surgery (LESS) totally extraperitoneal (TEP) inguinal hernia repair. Surg Endosc 25(9):2879–2883
Li J, Wang X, Feng X, Gu Y, Tang R (2013) Comparison of open and laparoscopic preperitoneal repair of groin hernia. Surg Endosc 27(12):4702–4710
Sayad P, Hallak A, Ferzli G (1998) Laparoscopic herniorrhaphy: review of complications and recurrence. J Laparoendosc Adv Surg Tech A 8(1):3–10
Choi YY, Han SW, Bae SH, Kim SY, Hur KY, Kang GH (2012) Comparison of the outcomes between laparoscopic totally extraperitoneal repair and prolene hernia system for inguinal hernia; review of one surgeon’s experience. J Korean Surg Soc 82(1):40–44
Zhang H, Lin J, Liao Q, Xie N, Gui X, Li J, Hong S, Qin X, Lu Y (2009) Totally extraperitoneal laparoscopic hernioplasty: the optimal surgical approach. Surg Laparosc Endosc Percutan Tech 19(6):501–505
Misra MC, Bhowate PD, Bansal VK, Kumar S (2009) Massive scrotal hernias: problems and solutions. J Laparoendosc Adv Surg Tech A 19(1):19–22
Sharma A, Mehrotra M, Khullar R, Soni V, Baijal M, Chowbey PK (2011) Laparoscopic ventral/incisional hernia repair: a single centre experience of 1242 patients over a period of 13 years. Hernia 15(2):131–139
Choi YY, Kim Z, Hur KY (2011) Laparoscopic total extraperitoneal repair for incarcerated inguinal hernia. J Korean Surg Soc 80(6):426–430
Choi YY, Kim Z, Hur KY (2011) Swelling after laparoscopic total extraperitoneal repair of inguinal hernias: review of one surgeon’s experience in 1065 cases. World J Surg 35(1):43–46
Lau H, Lee F (2003) Seroma following endoscopic extraperitoneal inguinal hernioplasty. Surg Endosc 17(11):1773–1777
Aravind B, Cook A (2013) Intra-abdominal giant infected seroma following laparoscopic inguinal hernia repair. Hernia Oct 26 (Epub ahead of print)
Saggar VR, Sarangi R (2005) Endoscopic totally extraperitoneal repair of incarcerated inguinal hernia. Hernia 9(2):120–124
Ferzli G, Shapiro K, Chaudry G, Patel S (2004) Laparoscopic extraperitoneal approach to acutely incarcerated inguinal hernia. Hernia 18(2):228–231
Morales-Conde S, Socas M, Fingerhut A (2012) Endoscopic surgeons’ preferences for inguinal hernia repair: TEP, TAPP, or OPEN. Surg Endosc 26(9):2639–2643
Wu CC, Kang JC, Huang YM (2012) Laparoscopic transabdominal preperitoneal hernioplasty for reduction en masse of an incarcerated inguinal hernia: a case report. J Gastrointest Surg 16(7):1433–1435
Jagad RB, Shah J, Patel GR (2009) The laparoscopic transperitoneal approach for irreducible inguinal hernias: perioperative outcome in four patients. J Minim Access Surg 5(2):31–34
Rebuffat C, Galli A, Scalambra MS, Balsamo F (2006) Laparoscopic repair of strangulated hernias. Surg Endosc 20(1):131–134
Siow SL, Mahendran HA, Hardin M, Chea CH, Nik Azim NA (2013) Laparoscopic transabdominal approach and its modified technique for incarcerated scrotal hernias. Asian J Surg 36(2):64–68
Ferzli GS, Rim S, Edwards ED (2013) Combined laparoscopic and open extraperitoneal approach to scrotal hernias. Hernia 17(2):223–228
Olmi S, Cesana G, Erba L, Croce E (2009) Emergency laparoscopic treatment of acute incarcerated incisional hernia. Hernia 13(6):605–608
Yalamarthi S, Kumar S, Stapleton E, Nixon SJ (2004) Laparoscopic totally extraperitoneal mesh repair for femoral hernia. J Laparoendosc Adv Surg Tech A 14(6):358–361
Bessa SS, Abdel-Razek AH (2013) Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated ventral hernias: a seven years study. Hernia 17(1):59–65
Daes J (2014) Endoscopic repair of large inguinoscrotal hernias: management of the distal sac to avoid seroma formation. Hernia 18(1):119–122
Othman I, Hady HA (2014) Hernia sac of indirect inguinal hernia: invagination, excision, or ligation? Hernia 18(2):199–204
Conflict of interest
DK G, SH W, CT Z, J C, M L, CW G and HR W declare no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Additional information
D. Gao and S. Wei are co-first authors.
Rights and permissions
About this article
Cite this article
Gao, D., Wei, S., Zhai, C. et al. Clinical research of preperitoneal drainage after endoscopic totally extraperitoneal inguinal hernia repair. Hernia 19, 789–794 (2015). https://doi.org/10.1007/s10029-014-1310-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10029-014-1310-0