To introduce a method of high ligation of pseudo-sac using hemo-o-lock in laparoscopic direct inguinal hernia repair, and to observe and evaluate its effect.

49 patients (60 sides) with direct inguinal hernia underwent laparoscopic trans-abdominal preperitoneal hernia repair (TAPP). Before placing the mesh, a clamp was used to pull out of the bottom of the pseudo-sac. Twist the clamp clockwise to make the sac to fried dough twist shape, then a large or extra-large hemo-o-lock was ligated on the base of the twister to close the defect. The closing time of pseudo-sac, the occurrence of postoperative seroma, local foreign body sensation, postoperative pain on the first and third days, hospital stays, and other postoperative complications were observed.

The average operation time was (45±14) min. There was no spermatic cord, blood vessel, nerve or viscera injury. A total of 60 sides of pseudo-sac in 49 cases were closed using hemo-o-lock. 46 sides achieved satisfactory results with one closure, 14 sides needed a second closure. The single operation time was 0.6-2 min, with an average of 1.0 min. The closure of the pseudo-sac was satisfactory on 50 sides (the defect disappeared after closure), and basically satisfactory on 10 sides (slight depressed 0.2-0.4 cm after closure). 3 days after operation, 2 cases had mild seroma, which was not treated. No analgesic was needed for mild pain on the first and third days after surgery. There is no obvious postoperative foreign body sensation in the groin area. The duration of hospitalization ranged from 1 to 7 days, with an average of 2.3 days. No recurrence, infection, pain or testicular atrophy were found during the follow-up at 1, 3 and 6 months postoperatively.

It is a simple, effective, and safe method to close the pseudo-sac of direct hernia by high ligation using a hemo-o-lock.