Risk factors for the development of sterile fluid accumulations (pssc) after endoscopic hernioplasty of inguinal hernias
https://doi.org/10.17238/2072-3180-2025-4-50-58
Abstract
Introduction. Inguinal hernioplasty is one of the most frequently performed operations in general surgery. Over the past decades, the introduction of minimally invasive technologies has shown advantages over traditional "open" techniques. However, one of the urgent problems remains postoperative fluid accumulation in the area of intervention. Despite the fact that such phenomena often have a favorable course, they can cause discomfort, slow down rehabilitation, and sometimes require additional interventions. Identification of PSSC risk factors is important for prevention and a personalized approach in the postoperative management of patients after inguinal hernioplasty.
The purpose of the study. To determine the frequency of occurrence of postoperative sterile serous clusters (PSSCS) and to identify the factors influencing their development in patients after endoscopic inguinal hernioplasty.
Materials and methods. The study was performed on the basis of the short-stay hospital of the O. M. Filatov Municipal Clinical Hospital № 15 of the Moscow Department of Health from January 1, 2024 to July 1, 2025. The analysis included patients who underwent laparoscopic inguinal hernioplasty using TAPP, TEP and their modifications.
Results. In a comparative analysis of quantitative variables between groups with and without PSSC, statistically significant differences were found in the following indicators: hernial sac size, age, BMI, and type of hernia.
Discussion. Inguinal hernioplasty remains one of the most common operations in general surgery, and in recent decades, endoscopic techniques such as TAPP and TEP have taken priority. Their benefits include reducing the intensity of postoperative pain, reducing recovery time, and reducing the risk of chronic pain.
Conclusions. Postoperative sterile serous accumulations were detected in 46,1 % of patients after laparoscopic inguinal hernioplasty. The independent risk factors for their formation were overweight, oblique type of hernia and increased duration of surgery
Keywords
About the Authors
E. A. KeshyanRussian Federation
Keshian Erik Ashotovich – MD, PhD, Surgeon, Department of Surgery No. 1; Assistant Professor, Department of Hospital Surgery No. 1 named after V.S. Mayat
23 Veshnyakovskaya St., Moscow, 111539;
1 Ostrovityanova St., Moscow, 117437
V. I. Vechorko
Russian Federation
Vechorko Valery Ivanovich – MD, PhD, Chief Physician; Head of the Department of Emergency and Urgent Medical Care, Institute of Postgraduate Education
23 Veshnyakovskaya St., Moscow, 111539;
1 Ostrovityanova St., Moscow, 117437
A. N. Severtsev
Russian Federation
Severtsev Alexey Nikolaevich – MD, PhD, Professor, Head of the Department of Hospital Surgery № 1 named after V.S. Mayat
1 Ostrovityanova St., Moscow, 117437
V. D. Anosov
Russian Federation
Anosov Viktor Davidovich – MD, PhD, Deputy Chief Physician for Surgical Care; Assistant Professor, Department of Hospital Surgery № 1 named after V.S. Mayat
23 Veshnyakovskaya St., Moscow, 111539;
1 Ostrovityanova St., Moscow, 117437
S. V. Ovchinnikov
Russian Federation
Ovchinnikov Sergey Vitalievich – MD, Surgeon, Head of the Short-Stay Surgical Unit
23 Veshnyakovskaya St., Moscow, 111539
E. A. Toneev
Russian Federation
Toneev Evgeny Aleksandrovich – MD, PhD, Associate Professor, Department of Hospital Surgery, Anesthesiology, Intensive Care, Urology, Traumatology and Orthopedics, Faculty of Medicine named after T.Z. Biktimirov, Institute of Medicine, Ecology and Physical Culture
AuthorID: 1043371
432017, Ulyanovsk
P. M. Chavkin
Russian Federation
Chavkin Petr Mikhailovich – MD, PhD, Surgeon, Short-Stay Surgical Unit
23 Veshnyakovskaya St., Moscow, 111539
D. S. Kostyaev
Russian Federation
Kostyaev Dmitry Sergeevich – MD, Surgeon, Department of Surgery
23 Veshnyakovskaya St., Moscow, 111539
A. V. Chernyakov
Russian Federation
Chernyakov Artem Viktorovich – MD, PhD, Head of the Department of Surgery
23 Veshnyakovskaya St., Moscow, 111539
References
1. Sigua B.V., Semin D.S., Kotkov P.A. and others. The effectiveness of various methods of surgical treatment of patients with inguinal hernias. Bulletin of Surgery named after I.I. Grekov, 2024, vol. 183, № 1, pр. 54–59. (In Russ.) https://doi.org/10.24884/0042-4625-2024-183-1-54-59
2. Loban K.M., Smirnova O.A., Andriashkin A.V. and others. Longterm results of laparoscopic hernioplasty in patients with inguinal hernias. Surgery. N.I. Pirogov Magazine, 2024, № 12, рр. 67–73. (In Russ.) https://doi.org/10.17116/hirurgia202412167
3. Lutsevich O.E. Alibekov K.T., Urbanovich A.S. Quality of life in patients after laparoscopic hernioplasty: disease recurrence and chronic pain syndrome. Moscow Surgical Journal, 2021, № 3(77), рр. 9–14. (In Russ.) https://doi.org/10.17238/2072-3180-2021-3-9-14
4. Transitions S.N., Gallyamov E.A., Vasilchenko M.I., Gadlevsky G.S. Early postoperative complications after hernioplasty by videolaparoscopic methods. Hospital medicine: Science and Practice, 2024, vol. 7, № 5, рр. 56–60. (In Russ.) https://doi.org/10.34852/GM3CVKG.2024.92.68.040
5. Tang S.S, Hao C.Z., Lee S.K.F., Loo L.M.A., Lomanto D. An update to the “TEP/TAPP plus” technique. Hernia, 2024. https://doi.org/10.1007/s10029-024-03147-0
6. Dias Rasador A.C., Balthazar da Silveira C. et al. Navigating hernia sac management in minimally invasive inguinal hernia repair: to abandon or to reduce? An updated systematic review and meta-analysis. Surgical Endoscopy, 2024. https://doi.org/10.1007/s00464-024-11323-7
7. Gallyamov E.A., Agapov M.A. and others. Laparoscopic approach in the treatment of inguinal hernias in patients after radical prostatectomy: comparison of TARR and TER results. Surgical practice, 2022, № 2(45), рр. 43–50. (In Russ.) https://doi.org/10.38181/2223-2427-2022-2-43-50
8. Tarasov E.E., Nishnevich E.V., Bagin V.A. and others. Total extraperitoneal plastic –TEP) of inguinal hernias under local anesthesia. Surgery. N.I. Pirogov Magazine, 2025, № 6, рр. 44–50. (In Russ.) https://doi.org/10.17116/hirurgia202506144
9. Ozel Y., Ergenc M., Emir S. et al. Comparative Analysis of Laparoscopic Totally Extraperitoneal (TEP) and Transabdominal Preperitoneal (TAPP) Techniques in the Treatment of Unilateral Inguinal Hernias. Ann Ital Chir., 2025.
10. Fang H., Lin R., Lin X. et al. Drainage decreases the seroma incidence in laparoscopic transabdominal preperitoneal (TAPP) hernia repair for large inguinoscrotal hernias. Asian J Surg., 2021, https://doi.org/10.1016/j.asjsur.2020.08.038
11. Morito A., Kosumi K., Kubota T. et al. Investigation of risk factors for postoperative seroma/hematoma after TAPP. Surgical Endoscopy, 2022. https://doi.org/10.1007/s00464-021-08814-2
12. Xie H., Chen B., Shen J. et al. Risk factors and clinical impact of seroma formation following laparoscopic inguinal hernia repair: a retrospective study. BMC Surg., 2024. https://doi.org/10.1186/s12893-024-02574-1
13. Aiolfi A., Cavalli M., Del Ferraro S. et al. Totally extraperitoneal (TEP) versus transabdominal preperitoneal (TAPP) hernioplasty: systematic review and trial sequential analysis of RCTs. Hernia, 2021. https://doi.org/10.1007/s10029-021-02407-7
14. Hajibandeh S., Kolli V.S., Kumar K., Hajibandeh S. Balloon versus telescopic dissection during laparoscopic TEP repair: systematic review, meta-analysis, and trial sequential analysis. Hernia, 2023. https://doi.org/10.1007/s10029-023-02793-0
15. Karkhani H.M.H., Gallyamov E.A., Vorotyntsev A.S. et al.Surgical treatment of purulent complications and widespread paraprosthetic infection in the area of the mesh prosthesis after laparoscopic transabdominal preperitoneal hernioplasty on the right side involving abdominal organs by laparoscopic access. Emergency medical care. N.V. Sklifosovsky Magazine, 2024, v. 13, № 3, рр. 528–533. (In Russ.) https://doi.org/10.23934/2223-9022-2024-13-3-528-533
Review
For citations:
Keshyan E.A., Vechorko V.I., Severtsev A.N., Anosov V.D., Ovchinnikov S.V., Toneev E.A., Chavkin P.M., Kostyaev D.S., Chernyakov A.V. Risk factors for the development of sterile fluid accumulations (pssc) after endoscopic hernioplasty of inguinal hernias. Moscow Surgical Journal. 2025;(4):50-58. (In Russ.) https://doi.org/10.17238/2072-3180-2025-4-50-58

















