Impact of Closed-suction Drain in Preperitoneal Space on the Incidence of Seroma Formation After Laparoscopic Total Extraperitoneal Inguinal Hernia Repair

Purpose: To study the effect of closed suction drain in preperitoneal space on seroma formation after laparoscopic total extraperitoneal repair (TEP). Methods: A closed suction drain-12G was put through the midline 5 turn port incision and removed with in 24 hours of operation in TEP repair. The results were compared with a group with TEP without any drain. Results: In 929 patients (1753 hernias), drain was put in 849 patients (1607 hernias) and no drain was put in 80 patients (146 hernias). Follow-up ranged from 9 to 45 months. Seroma formation was significantly lower in the drain group (12/1607; 0.75%) compared with the nondrain group (22/146; 15.1%) (P < 0.0001). Both the groups were comparable in pain scores, conversion to open, hospital stay, and days taken to return to normal activity and recurrence rates. There was no infection in either group Conclusions: Drain after TEP significantly reduces the incidence of seroma formation without increasing the risk of infection or recurrence.