A Novel Technique for Inguinal Hernia Repair in Patients With Nonmalignant Ascites

We report a novel approach to open inguinal hernia repair in patients with known ascites in which the cord, hernia sac, and attached testicle on the affected side are repositioned into the retroperitoneum through the inguinal ring. By avoiding invasion of the peritoneum and limiting dissection of the sac off the spermatic cord, the risk of ascites leak and testicular ischemia is theoretically decreased.

This is a retrospective case series report. Medical records of patients with ascites (n = 7) who underwent this novel repair technique were reviewed. All surgeries were performed at a tertiary referral center between January 2022 and January 2024.

This surgical technique was performed on seven patients with inguinal hernias, all of whom had known ascites. Of these seven patients, none experienced postoperative inguinal hernia recurrence or ascitic leakage. However, three developed scrotal hematomas, and one experienced scrotal edema and postoperative constipation.

This technique may help reduce the risk of recurrence and ascitic leakage in this specific patient population.