Transabdominal Suturing of Internal Inguinal Orifice During Laparoscopic Tapp Repair of L3 Hernias: 6-Month Follow-Up of 15 Patients

Abstract Aim To present mid-term follow-up data on suturing of the internal inguinal orifice during transabdominal preperitoneal (TAPP) repair of large inguinal hernias. Methods This study involved a prospective documentation of surgical outcomes and quality of life in patients with large indirect inguinal hernias who underwent laparoscopic internal ring suturing during TAPP repair. Results Between November 2022 and March 2023, 15 patients underwent laparoscopic transabdominal repair of symptomatic L3 inguinal hernias, which included suturing of the internal inguinal ring and preperitoneal mesh placement. All patients were men, with a mean age of 42.4 years (range 23–74). The average size of the hernia defect was 3.8 ± 0.3 cm (range: 3.0–5.4 cm). The mean operative time was 56.8 ± 8.2 minutes (range: 36.2–85.7 minutes), and the time required for internal ring suturing averaged 8.2 ± 1.9 minutes (range: 5.2–11.6 minutes). Patients were assessed clinically for signs of hematoma, seroma, or recurrence on the 1st and 7th postoperative day, and at the 3rd and 6th postoperative month. Additionally, postoperative pain and comfort were assessed using the Visual Analogue Scale (VAS) for pain and the Carolinas Comfort Scale, respectively. All patients reported no postoperative pain and exhibited excellent comfort levels. Conclusions Transabdominal internal ring suturing during laparoscopic TAPP repair of L3 inguinal hernias appears to be safe, is not associated with chronic pain, and helps in reconstituting the floor of the inguinal canal for mesh placement. This technique potentially reduces mesh eventration and the consequent risk of recurrence.