To explore the clinical effect of suture closure of the inner ring defect in laparoscopic transabdominal preperitoneal(TAPP) large indirect inguinal hernia repair.

From February 2022 to October 2022, 38 patients (46 sides) with large indirect inguinal hernia (European Hernia Society classification L3 or above or scrotal hernia) who underwent TAPP at the Department of Gastrointestinal Surgery, the First Affiliated Hospital of Wannan Medical College were enrolled in this retrospective study. During the operation, the hernia ring defect (internal ring opening) was sutured before the mesh was implanted. The perioperative data were recorded, and the occurrence of postoperative complications (severe postoperative pain, intestinal obstruction, incision related complications, mesh infection, hematoma, seroma, persistent refractory pain, and recurrence) was observed.

All 38 cases (46 sides) were operated on by the same surgeon. The average defect of hernia ring was (3.5±0.5) cm. The mean operation time was (58.3±11.9) min, and the mean time to close the inner ring was (8.7±3.2) min. The intraoperative blood loss was minimal. The mean resting visual analogue scale (VAS) was 2.5 on the first postoperative day. The average postoperative hospital stay was 22 hours. No severe pain, intestinal obstruction, incision-related complications, mesh infection or hematoma occurred in the early postoperative period. Mild seroma occurred in 3 sides (6.5%) on the 7th day after operation, with an average volume of 40.5ml. All seromas resolved spontaneously within 2 months. The patients were followed up for 2 to 10 months, with an average of 5.4 months. No persistent refractory pain or hernia recurrence occurred.

In TAPP for large indirect inguinal hernia, the application of the inner ring defect closure method can significantly reduce the formation of postoperative seroma and related complications.