Page 25 - World Journal of Laparoscopic Surgery

ORIGINAL ARTICLE
Postoperative Seroma Collection in Operated Case of TAPP

Hernioplasty in Unilateral Inguinoscrotal Hernia

1
2
Ronak R Modi , Jatinkumar B Modi , Harshil D Modi 3
AbstrAct
Introduction: Repair of inguinal hernia is one of the commonest performed surgical procedures worldwide. Usually, a seroma develops in
large inguinoscrotal hernias. Generally, a seroma is a cause of significant distress for the patient since it may recur. If the possibility of seroma
formation is discussed with the patient before surgery, it may go a long way in alleviating the patient’s distress. Seromas are common after
large hernia repair and direct hernia repair.
Materials and methods: In this observational study, 50 patients were randomly selected from LG. Hospital (AMC MET Medical College,
Ahmedabad, India) who went through TAPP hernioplasty for an inguinoscrotal hernia after a complete explanation of conversion to open as
well as post-operative seroma formation. Since all cases were indoor patients, they were initially reviewed on the next day morning after the
operation and the next examination time point was seven days later for seroma development. All the patients were followed up at 6 weeks and
then every month for 6 months up to 1 year.
Results: Out of 50 patients, 44 (88%) patients had an indirect hernia and 6 (12%) patients had a direct hernia. The seroma developed in only three
patients (6%) who were managed conservatively with only medicines. Within the follow-up period, no patients had pain, seroma, and recurrence.
Conclusion: In some cases of large scrotal hernia, the distal sac was difficult to be inversed or the hernia sac even adhered firmly to the ipsilateral
testicle and other structures. In those cases, avoiding inverting the distal sac and leaving the distal sac in place means to avoid dissecting out
the distal sac observed lesser occurrence of the seroma. That suggests that the laparoscopic method can help prevent or decrease the chance
of the development of seroma in the unilateral inguinoscrotal hernia.
Keywords: Hernia, Hernioplasty, Inguinoscrotal hernia, Laparoscopy, Laparoscopic hernia repair, Laparoscopic inguinal hernia repair, Seroma,
Transabdominal preperitoneal.
World Journal of Laparoscopic Surgery (2021): 10.5005/jp-journals-10033-1434

IntroductIon
1–3 Department of General Surgery, AMCMET Medical College, Sheth
Repair of inguinal hernia is one of the commonest surgical L.G.Municipal General Hospital, Maninagar, Ahmedabad, Gujarat, India
procedures performed worldwide. The lifelong risk for males is Corresponding Author: Jatinkumar B Modi, Department of
1
27% against 3% for females. Since Bassini published his landmark General Surgery, AMCMET Medical College, Sheth L.G.Municipal
paper about the manner of tissue repair in 1887, numerous General Hospital, Maninagar, Ahmedabad, Gujarat, India,
modifications have been proposed. Shouldice four-layer inguinal Phone: +91 9727772479, e-mail: jatin50100@gmail.com
hernia repair technique enjoyed extensive popularity before the How to cite this article: Modi RR, Modi JB, Modi HD. Postoperative
idea of prosthetic material was introduced. Hence, tissue repair may Seroma Collection in Operated Case of TAPP Hernioplasty in Unilateral
be the commonest type of hernia repair in the developing world. Inguinoscrotal Hernia. World J Lap Surg 2021;14(1):23–25.
But, with tissue repair comes the manipulation of the tissue, which Source of support: Nil

can lead to the increased risk of seroma formation. Conflict of interest: None
There has been a revolution in surgical procedures for
groin hernia repairs after the introduction of laparoscopy. Ger
documented the first laparoscopic hernia repair in 1982 by
2
approximating the internal ring with stainless steel clips. Since
then, laparoscopic trans-abdominal preperitoneal repair (TAPP) is is discussed with the patient before surgery, it can significantly
an increasingly innovative technique within hernia surgery and is reduce patients’ distress. The occurrence of seromas is common
now equally effective in preventing recurrence. The TAPP approach after large hernia and direct hernia repair. 2–4 Seroma formation
of laparoscopic hernia repair replicates the concept of Stoppa repair. is very common throughout the learning phase and decreases
The benefits of laparoscopic repair include the reduced incidence with increasing experience. TAPP techniques are the most widely
of recurrence similar to as noticed using the Stoppa technique adopted laparoscopic procedures for inguinal hernia repair with
that has the advantages of lesser pain, reduced discomfort, less favorable clinical outcomes, such as shorter hospital study, minimal
tissue dissection, and manipulation, short hospital stay, and earlier postoperative pain, and decreased surgical site infection (SSI).
resumption of normal daily activities. However, seroma formation is the most frequent complication
2,5
2
Usually, seroma develops in the large inguinoscrotal hernias. after laparoscopic repair. In this study, we aimed to study the
Seroma generally is a cause of significant distress for the patient, occurrence of seroma formation in operated cases of unilateral
since it may recur frequently. If the possibility of seroma formation inguinoscrotal hernia by laparoscopic methods.

© Jaypee Brothers Medical Publishers. 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License
(https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give
appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons
Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.