Suturing the lax pseudosac to the Cooper's ligament to prevent seroma in endoscopic hernia repair

Seroma formation after laparoscopic or robotic inguinal hernia repair is a known complication, causing nuisance to the patient and embarrassment to the surgeon. A method of fixing the lax pseudosac of direct inguinal hernia to Cooper's ligament by suturing, to prevent post-operative seroma formation, is discussed in this study. Seventy-two pseudosac fixations were done in a 'figure of eight technique' using non-absorbable suture in 56 patients. These patients were followed up 2 weeks and 6 weeks post surgery. None developed a seroma. The primary obliteration of pseudosac by suturing with non-absorbable suture to Cooper's ligament is a cheap and reliable method for prevention of post-operative seroma. However, it is time-consuming and dependent on the suturing skill of the surgeon.