Percutaneous inguinal canal semi-closure during laparoscopic repair for large indirect inguinal hernia

Factors such as a large lateral hernia and insufficient prosthetic overlap have been associated with hernia recurrence after laparoscopic transabdominal preperitoneal (TAPP) repair. The effectiveness of defect closure in reducing recurrence during laparoscopic hernia repair has been previously reported. We developed a novel technique called percutaneous inguinal canal semi-closure (PICS) to reinforce laparoscopic mesh repair.

To assess whether this technique is both safe and practical in a clinical setting, focusing on postoperative factors such as recurrence, complications, and postoperative pain.

A retrospective analysis of consecutive patients undergoing TAPP for L3 hernia repair.

In total, 58 patients who underwent TAPP for L3 inguinal hernias were included, 27 of whom (46.6%) underwent TAPP with PICS, while 31 (53.4%) underwent standard TAPP without PICS. No recurrences were observed in the PICS group, compared to two recurrences in the control group, although this difference did not reach statistical significance. The incidence of postoperative complications was comparable between groups (48.1% vs. 45.2%, respectively). The median procedure time of PICS was 7.3 min. Patients in the PICS group reported higher pain scores than the control group for up to 21 days postoperatively, but no chronic pain was observed in either group.

The modified laparoscopic technique involving PICS for large indirect inguinal hernias appears safe and feasible.