探讨腹腔镜腹股沟斜疝无张力修补术中关闭疝环的临床价值，阐述手术操作流程和技术细节，分析其可行性及有效性。

本研究为前瞻性研究，选择2019年5月至2020年11月南方医科大学附属何贤纪念医院腹股沟斜疝患者（内环缺损≥3 cm或者为阴囊疝）的临床资料。研究患者均行腹腔镜完全腹膜外疝修补术（TEP）或腹腔镜经腹腹膜前疝修补术（TAPP）手术，并采取缝合关闭内环口的操作，记录围手术期情况以及术后并发症情况，包括术后疼痛及疝复发率，观察术后血清肿发生情况。

共完成27例34侧TEP手术和12例15侧TAPP手术，所有手术均顺利完成。TEP组手术时间单侧平均55 min，双侧平均95 min；TAPP组单侧平均63 min，双侧平均115 min。术中出血少，术后伤口疼痛轻，术后平均住院时间18 h。随访时间2～17个月，未见复发，无慢性疼痛病例。TEP组5例，TAPP组3例发生术后血清肿，程度均较轻，持续1～3个月自行吸收，无需穿刺抽或其他治疗。

腹腔镜下斜疝的内环口缝合是安全可行的，能有效减少术后血清肿及其相关的并发症，适合在Ⅲ型斜疝或者阴囊疝病例中施行。

To investigate the application of defect closure technique in laparoscopic herniorraphy for indirect hernia. The procedure will be described in details and its safety and efficacy are evaluated.

This prospective study was conducted from May 2019 to November 2020. Patients with EHS type Ⅲ indirect hernia or scrotal hernia were recruited, and they were treated by TEP/TAPP repair according to the individual situation. A hernia defect closure manipulation was performed before the mesh implantation. Perioperative data and the postoperative complications were recorded, including pain issue and hernia recurrence. The seroma formation issue was the key parameter that be focused on.

A consecutive of 27 patients of 34 sides TEP procedures and 12 patients of 15 sides TAPP procedures were enrolled in our study. All operations were successful without open conversion. The mean operative time in TEP group was 55 minutes for unilateral hernia and 95 minutes for bilateral, while it was 63 minutes and 115 minutes correspondingly in TAPP group. Intraoperative bleeding was minimal and postoperative pain was mild. The mean postoperative hospital stay was 18 hours. During a follow-up period of 2 to 17 months, no hernia recurrence or chronic pain was noted. The seroma formation was 5 cases in TEP group and 3 cases in TAPP group, and they were all mild and resolved in 1 to 3 months spontaneously, without need for aspiration or other treatment.

The application of defect closure technique in laparoscopic herniorraphy for indirect hernia is safe and feasible, and it can significantly reduce the postoperative seroma formation and relative complications, which is recommended to implement in type Ⅲ indirect hernia or scrotal hernia patients.