Primary Abandon of Hernia Sac (PAS) Versus Complete Dissection in Laparoscopic Transabdominal Preperitoneal (TAPP) Repair of Large Inguinal and Inguinoscrotal Hernia: A Prospective Randomized Pilot Study.

Abstract

<h4>Background</h4>Inguinal hernia repair (IHR) is a common surgical approach globally, with laparoscopic techniques like transabdominal preperitoneal (TAPP) repair growing in popularity due to their minimally invasive nature and favorable patient outcomes. The aim of this study was to evaluate the results of the primary abandon of the hernia sac (PAS) technique in laparoscopic TAPP for large inguinal and inguinoscrotal hernias (ISH).<h4>Methods</h4>This prospective randomized pilot study was conducted on 53 patients aged between 16 and 70 years, diagnosed with unilateral or bilateral uncomplicated inguinoscrotal or large inguinal hernias. All participants were allocated into two groups: Group A underwent the PAS approach, while Group B underwent the complete sac dissection approach.<h4>Results</h4>Operative time was significantly increased in group B compared to group A (45.2±7.8 min vs. 60.6±20.1 min) (p=0.001). There were insignificant differences in postoperative seroma and hydrocele rates between the groups (p=1.0). Likewise, no significant difference was observed regarding the hernia side (p=0.893), operative complications, or other postoperative issues. Postoperative pain (POP) scores and length of hospital stay (LOS) also displayed insignificant differences between the groups.<h4>Conclusions</h4>The primary abandon sac technique in TAPP for large inguinal and inguinoscrotal hernias notably shortened operative time without raising rates of seroma, hydrocele, intraoperative or postoperative complications, pain, length of hospital stay, or one-year recurrence.