Comparison of Two Surgical Techniques for Indirect Inguinal Hernia Repair

This study will compare two ways of managing the hernia sac during laparoscopic surgery for an indirect inguinal hernia, a type of groin hernia. A hernia sac is a pouch of tissue that extends through the hernia opening. In the standard technique, the sac is fully separated from nearby structures and returned to the abdomen. In the alternative technique, called Primary Abandon of the Sac (PAS), the lower part of the sac is left in place to reduce the amount of tissue dissection. Both techniques use mesh to repair the hernia. The main question is whether leaving the lower part of the sac in place results in an acceptably similar rate of seroma compared with the standard technique. A seroma is a collection of fluid near the area where surgery was performed. The study will also compare operation time, pain, quality of life, complications, return to daily activities, and whether the hernia comes back. The study plans to enroll 90 adults with a primary indirect inguinal hernia on one side who are scheduled for elective laparoscopic repair. Participants will be assigned by chance to one of the two surgical techniques, with an equal chance of receiving either technique. Participants and the researchers assessing their recovery will not know which technique was used; the operating surgeon will know. Participants will have follow-up assessments at 1 day, 7 days, 1 month, 6 months, and 12 months after surgery. The main assessment of seroma will take place 30 days after surgery.

Inclusion Criteria: * Age 18 years or older. * Primary unilateral indirect inguinal hernia. * Scheduled for elective laparoscopic inguinal hernia repair. * Suitable for general anesthesia and laparoscopic surgery. * Provision of written informed consent. Exclusion Criteria: * Bilateral inguinal hernia. * Recurrent inguinal hernia. * Direct inguinal or femoral hernia without a qualifying indirect inguinal hernia. * Incarcerated or strangulated hernia requiring emergency surgery. * Sliding hernia. * Large spermatic cord lipoma. * Previous preperitoneal surgery. * Contraindication to general anesthesia or laparoscopic surgery.