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.