Prospective evaluation of the giant prosthetic reinforcement of the visceral sac for recurrent and complex bilateral inguinal hernias

The Stoppa procedure in inguinal hernia repair: to drain or not to drain

“…Further we believed that 1 suction drain was sufficient by assuming that the preperitoneal space created by the surgical dissection represented only 1 bilateral continuous space; in fact, this strategy worked effectively. Aspirative drainage in GPRVS was responsible for 2 to 7 days of postoperative hospital stay with a mean of 3.5 days, which is compatible to the findings of others 11,14,16,20 . Of the patients who did not undergo drainage, 85.7% presented with preperitoneal fluid collection revealed by CT scan on the second POD, but this was diagnosed clinically in only 21.4%, with minimal clinical evidence that did not require any specific treatment.…”

“…Thus, the results presented from Group A on clinical evaluation are similar to those reported by Solorzano et al 16 and Beets et al 12 who also did not use drainage systematically in GPRVS. Solorzano et al 16 reported 14% hematoma and infectious complications while Beets et al 12 reported 22.6% seroma, hydrocele, hematoma, and infectious complications.…”

“…Recent publications about the GPRVS have revealed that there still are authors who routinely use drainage with this procedure 15,17 ; however, some others do not use drainage 12,16 , and some eventually use drainage 13,20 . When we looked for potential complications reported in these publications that might have arisen from fluid collections (seroma, hematoma, and infection), we found the following complication rate: 1) routine drainage: 3% 15 and 9% 17 ; 2) use of suction drain according to intraoperative parameters: 10.2% 20 and 24.6%…”

“…Sometimes this drainage procedure is responsible for longer hospitalization that may be as long as 9.7 days 11 . Since the description of GPRVS procedure, many surgeons have reported good outcomes; however, whether drainage is mandatory or how many suction drains should be placed in the preperitoneal space at the time of intervention is still controversial 8,9,[12][13][14][15][16][17][18][19] . The purpose of this study was to analyze the actual benefit of drainage in the GPRVS procedure and to answer the question of whether drainage is better than no drainage.…”

“…; and 3) no drainage: 14% 16 and 22.7% 12 . From these data, it appears that the use of a suction drain would bring some benefit.…”