RESUMO
BACKGROUND: A laparoscopic approach to repair of inguinal hernia has become popular. The reduction of an indirect sac can be challenging especially if it is long standing or is large. In such situations, the established practice is to divide the sac at the neck and ligate it. Ligation of the sac has been shown to cause increased postoperative pain. Hence we postulated that we could possibly avoid ligation of this divided sac without causing increased intraoperative difficulty or postoperative complications. METHODS: This was a retrospective review of a prospectively maintained database of all patients who underwent laparoscopic totally extraperitoneal repair (TEP) during a 7-year period at our center with a minimum of 1 year of follow-up. We compared the outcomes of the patients who underwent only a division (group I) versus those who underwent division followed by ligation (group II) of the indirect sac. RESULTS: There were 189 and 126 patients in groups I and II, respectively. Group I patients fared better in terms of operative times and postoperative pain scores. The postoperative complication and short-term outcomes were not significantly different between the two groups. CONCLUSION: Non-ligation of a divided indirect sac during TEP is feasible and has the advantages of reduced operative times and postoperative pain and does not lead to increased complications.
