To compare the postoperative complications of sac transection and complete sac reduction for indirect hernia during laparoscopic trans-abdominal preperitoneal repair (TAPP).

The data of 166 male unilateral indirect hernia patients who underwent TAPP procedure in Liyang Branch of Jiangsu Provincial People's Hospital from January 2016 to June 2020 were retrospectively analyzed. The patients were classified into two groups according to surgical methods: the transected sac group (86 cases) and the completely reduced sac group (80 cases). The postoperative pain, hernia recurrence and seroma formation were compared between two groups.

There was no significant difference in the acute postoperative pain and chronic pain between the two groups (P>0.05). The incidence of seroma at 2 and 7 days after the operation in the sac transection group (18.6% and 27.8%) was higher than that in the complete sac reduction group (7.5% and 15.0%), and the difference was statistically significant (P<0.05). The seroma disappeared spontaneously 3 months after the operation. All patients were followed up for 6 to 36 months without recurrence.

Complete sac reduction during TAPP has the same efficacy as sac transection. Surgeons can choose transection or reduction according to the patient's intraoperative situation. Although transection of the hernia sac during TAPP repair may cause seromas, it will heal spontaneously within 3 months.