Laparoscopic management of pseudo sac in inguinal hernia

Background

Pseudosacs in hernia are a culprit for formation of seroma which is a common nuisance

encountered by surgeons in postoperative period of any hernia surgeries.

Although minimally invasive approaches have reduced the postoperative morbidity in hernia

patients, complications like seroma formation are unavoidable. We are presenting different

methods we have used for management of pseudo-sac and their outcomes.

Methods

Different methods we have used are as follows

1) Tucking of sac, 2) Fenestration of sac, 3) Excision of sac, 4) leaving the sac behind All

these methods are simple, feasible and effective

Results

Out of 80 patients who underwent inguinal hernia repair at our institution, in around 10

patients fenestration of sac was performed, tucking of sac was done in 12 patients, 2

underwent excision of sac and in the rest sac was left behind.

After a long term follow up only 2 patients developed seroma

Conclusion

All these methods mentioned above are feasible and effective with more or less similar

results . Their efficacy over one another is yet to be proven

References

● Lodha M, Meena SP , Parihar YK, Badkur M, Puranik AK, Kompally PV . A newer method of seroma reduction by fenestration of pseudo-sac during

laparoscopic repair of direct inguinal hernia: A randomised, controlled pilot study. J Minim Access Surg. 2023 Jan-Mar;19(1):69-73. doi:

10.4103/jmas.jmas

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21. PMID: 35915521; PMCID: PMC10034800.

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