Effect of closed drainage system on prevention of seroma after laparoscopic total extraperitoneal repair in primary M3 and L3 inguinal hernia

INTRODUCTION: Seroma that can be seen after endoscopic completely extraperitoneal inguinal hernioplasty (TEP) is a major problem in patients who are concerned about recurrence. In this study, a prospective study design was prepared in our clinic in order to see the incidence of seroma after TEP and the effect of closed system negative pressure drainage, which is one of the methods thought to reduce it.
METHODS: Primary M3 and L3 unilateral inguinal hernias were randomly divided into two groups. Group I was the group in which a drain was placed after TEP, and Group II was the group in which no drain was placed after TEP. In Group I patients, a hemovac drain was placed behind the mesh and the perforated end of the drain was placed in the preperitoneal space. Anatomical 3D mesh (3DMax™ Mesh, BD, USA) was applied to all cases.
RESULTS: There were 41 patients in Group I and 39 patients in Group II. 73 of the patients were men and 7 were women. According to the EHS classification, 47 of the hernias were L3 type and 33 were M3 type. Seroma was detected in 5 patients in Group I and 13 patients in Group II on the 7th postoperative day (p<0.024). There was no difference between the groups in the seromas seen in the 3rd month after surgery.
DISCUSSION AND CONCLUSION: Seroma is common after TEP, especially in M3 and L3 hernias. This situation is confused with hernia recurrence in the patient. This may cause fear and panic in the patient. The drainage system installed in large hernias in the early postoperative period reduces the development of seroma and these concerns are eliminated. In addition, having patients come to the team performing the surgery for check-ups at regular intervals is effective in relieving patients’ concerns.