Laparoscopic Transabdominal Preperitoneal Approach with Abandon Sac Technique in Management of Large Inguinoscrotal Hernia; Randomized Clinical Trial

Yassin, Mahmoud Abdou; Atef, Baher; Ramadan, Alaaedin; Elaidy, Mostafa M.

doi:10.21608/ejhm.2022.264526

Laparoscopic Transabdominal Preperitoneal Approach with Abandon Sac Technique in Management of Large Inguinoscrotal Hernia; Randomized Clinical Trial

Document Type : Original Article

Authors

Faculty of medicine , Zagazig university ,Egypt

10.21608/ejhm.2022.264526

Abstract

Background: Inguinoscrotal hernia is the commonest type of all hernias. Although, Lichtenstein tension-free technique was the main procedure for its repair, laparoscopic transabdominal preperitoneal (TAPP) approach has been widely used, but with a great challenge for large size hernia. In this article, we described a modified laparoscopic trial in order to overcome this obstacle by transecting the large hernia sac, vice complete intra-abdominal inversion.
Objective: This study aimed to evaluate the initial results of a modified TAPP technique (abandon sac trial), in laparoscopic management of large inguinoscrotal hernia type I.
Patients and methods: Our study was conducted at Zagazig University Hospitals, on 50 cases of large inguinoscrotal hernia type I through the period from January 2021 and June 2022.
Results: As regards surgical results, both scrotal edema and hematoma were reported in 6% and seroma in 12%. While there was no detected cases of either infection, funiculitis, chronic groin pain or recurrence. Postoperative pain was mild to moderate, and the hospital stay was 1-2 days only.
Conclusion: A large inguinoscrotal hernia type I, can be managed safely with introduction of a slight modification on the TAPP laparoscopic method (abandon sac technique). With this modification, big size hernias will have a chance to be managed laparoscopically and obtained its advantages as small wound size and marked reduction of both postoperative pain, and recurrence.

Keywords