To investigate the clinical efficacy between hernia sac dissection and sac transection in laparoscopic trans-abdominal preperitioneal herniorrhaphy (TAPP) in treatment of unilateral Gilbert III inguinal hernia in adult males.

The clinical data of 60 cases of male inguinal hernia (Gilbert Ⅲ) treated in Xuzhou Traditional Chinese Medicine Hospital were retrospectively analyzed. All patients were treated with TAPP, and they were divided into the sac transection group (n=26) and sac dissection group (n=34). The operation time, intraoperative bleeding, scores of visual analogue scale (VAS), incidence of complications, length of hospital stay and postoperative recurrent rate were observed and compared between the two groups.

The operation time and the amount of bleeding during operation were significantly higher in the sac dissection group than those in the sac transection group (t=5.020, 6.832, both P<0.05). The scores of VAS in the sac transection group were significantly lower than those in the sac dissection group on the first day after operation (t=5.266, 3.933, all P<0.05). The incidence of complications in the sac transection group was lower than that in the sac dissection group (χ²=4.343 9, P<0.05). There were no significant differences between the two groups in length of hospital stay and postoperative recurrent rate of hernia (χ²=0.700 2, P>0.05).

Both methods can achieve satisfactory clinical outcome, but the transection method has the advantages of short operative time, low scores of VAS, less bleeding and complications.