Effect of hernia sac transection on the outcomes of laparoscopic hernia repair for unilateral Gilbert type-III inguinal hernia

Abstract

BACKGROUND: To investigate the effect of laparoscopic herniorrhaphy on the treatment of unilateral Gilbert type-III inguinal hernia.

METHODS: This study retrospectively reviewed medical records of 325 individuals who underwent minimally invasive laparoscopic surgery for unilateral Gilbert type-III inguinal hernias at the Ninth People’s Hospital affiliated with Shanghai Jiaotong University Medical College, with data collection occurring between January 2021 and May 2024. The cohort was stratified into two surgical groups: Partial resection (n = 180) receiving transection procedures versus radical resection (n = 145) undergoing complete sac dissection, determined by intraoperative decision-making. The ages, body mass index values, operation modes, operation times, intraoperative bleeding levels, postoperative pain scores, postoperative hospital stays, postoperative seroma rates, postoperative chronic pain levels, postoperative hematoma rates, incision infection rates, and hernia recurrence rates of the patients in the two groups were analyzed and compared.

RESULTS: The transection group demonstrated a marked reduction in postoperative seroma occurrence relative to the complete dissection cohort, with statistical significance confirmed (P < 0.05). There were no significant differences between the two groups in intraoperative bleeding, operation times, postoperative hospital stays, postoperative pain scores, postoperative chronic pain levels, postoperative hematoma rates, or incision infection rates (P > 0.05). Continuous surveillance spanning 12 months revealed equivalent therapeutic durability across both treatment arms, with no hernia reappearance detected.

CONCLUSION: For patients requiring laparoscopic repair of unilateral Gilbert type-III inguinal hernias, intraoperative sac transection is an effective strategy, particularly in cases where the hernia sac is long and complete dissection is difficult, as it may be the preferable option and can significantly reduce the risk of postoperative seroma formation.

Keywords

Gilbert type-III / inguinal hernia / laparoscopes / seroma / transection / unilateral

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International Journal of Abdominal Wall and Hernia Surgery | Published by Wolters Kluwer - Medknow on behalf of Higher Education Press