Postoperative complications in laparoscopic para-umbilical hernia repair: A comparative study of sac excision versus non-excision

Background: Para-umbilical hernias are among the most frequently encountered abdominal wall hernias in adults. Laparoscopic repair has become a preferred technique due to its minimally invasive nature. However, the role of hernial sac excision in improving post-operative outcomes remains controversial.Aim and Objectives: To compare post-operative complications between excision and non-excision of the hernial sac during laparoscopic para-umbilical hernia repair, with particular emphasis on seroma formation and other early post-operative complications.Materials and Methods: This non-randomized comparative study was conducted at Tertiary care Hospital, Pune. 92 patients with paraumbilical hernias were planned to undergo laparoscopic repair with or without hernail sac excision: Group A underwent laparoscopic repair with hernial sac excision, and Group B without sac excision. Post-operative complications including pain, seroma, skin necrosis, wound gaping, discharge, fever, and bowel function were evaluated on POD 3, 7, 14, 30, and 45.Results: On POD 14 and POD 30, Group A showed a statistically significant reduction in the incidence of seroma, wound-related complications, and pain compared to Group B (p < 0.001). Seroma was particularly reduced in the excision group, suggesting an association between sac excision and decreased fluid accumulation. By POD 45, most complications had resolved in both groups, with no significant difference. Conclusion: Excision of the hernial sac during laparoscopic para-umbilical hernia repair may contribute to reduced early post-operative complications, particularly seroma formation. These findings support the inclusion of sac excision as a standard step in laparoscopic repair. However, further studies with larger sample sizes and longer follow-up are needed to validate these outcomes.