{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T11:58:49Z","timestamp":1793275129531,"version":"4.5.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002386","name":"Cairo University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002386","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hernia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purposes<\/jats:title>\n                    <jats:p>Seroma is a frequent complication after laparoscopic hernias repair. Many techniques have been proposed to mitigate this issue, yet no approach has been standardized. This study aimed to evaluate the effectiveness of transversalis fascia plication to reduce this.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This randomized controlled trial was conducted at University Hospital from Jule 2024 to October 2025 after approval by the research ethics committee (MS-142-2024), involving adult patients who underwent TAPP repair for direct inguinal hernia. Exclusion criteria were indirect\/pantaloon or recurrent hernias, conversion to open surgery, and concurrent procedures. Patients were randomized into two groups by ratio1:1 using computer-generated random sequence with opaque sealed envelopes opened only intraoperative after confirmation of direct hernia: Group A: underwent plication of the fascia transversalis, while the other did not. The primary outcome was the incidence of postoperative seroma. Secondary outcomes included postoperative recovery parameters and the complications. Secondary outcomes included postoperative recovery parameters and the complications.Statistical analysis was performed using SPSS version 27.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>146 patients met the inclusion criteria. Demographic characteristics, preoperative comorbidities and hernia size were similar across both groups. At day 30 follow-up, 9 patients (12.3%) in the control group developed clinically detectable seromas, whereas none were in the plication group (p =0.002). Additionally, the plication group demonstrated a significantly faster return to normal activity and better pain scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Plication of the transversalis fascia during TAPP may reduce the incidence of seroma formation, and improve postoperative outcomes. Before starting the study, the trial was registered and approved by institutional research ethics committee (MS-142-2024).online, retrospectively registered on the Pan African Clinical Trials Registry (PACTR202511671623081).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10029-026-03623-9","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T09:44:40Z","timestamp":1773740680000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Plication of fascia transversalis in comparison to no plication to reduce seroma formation post laparoscopic transabdominal preperitoneal repair for direct inguinal hernia : a randomized controlled trial"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3661-3610","authenticated-orcid":false,"given":"Mohammed Elshwadfy","family":"Nageeb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George Abdelfady","family":"Nashed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Abdelrahman Ali","family":"Asal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled Mosleh","family":"Torfa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"3623_CR1","doi-asserted-by":"publisher","unstructured":"Caruso G, Evola G, Benfatto SAM, Gangemi M (2022) Transabdominal preperitoneal (TAPP) inguinal hernia repair. Hernia Surgery. Springer, Cham. pp 77. https:\/\/doi.org\/10.5772\/intechopen.101962","DOI":"10.5772\/intechopen.101962"},{"issue":"2","key":"3623_CR2","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1002\/ags3.12314","volume":"4","author":"Y Takayama","year":"2020","unstructured":"Takayama Y, Kaneoka Y, Maeda A, Takahashi T, Uji M (2020) Laparoscopic transabdominal preperitoneal repair versus open mesh plug repair for bilateral primary inguinal hernia. Ann Gastroenterol Surg 4(2):156\u2013162 https:\/\/doi.org\/10.1002\/ags3.12314","journal-title":"Ann Gastroenterol Surg"},{"issue":"5","key":"3623_CR3","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1007\/s10029-007-0233-4","volume":"11","author":"VM Reddy","year":"2007","unstructured":"Reddy VM, Sutton CD, Bloxham L, Garcea G, Ubhi SS, Robertson GS (2007) Laparoscopic repair of direct inguinal hernia: a new technique that reduces the development of postoperative seroma. Hernia 11(5):393\u2013396 https:\/\/doi.org\/10.1007\/s10029-007-0233-4","journal-title":"Hernia"},{"issue":"3","key":"3623_CR4","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1177\/1553350620960976","volume":"28","author":"R Di Pini","year":"2021","unstructured":"Pini R, Mongelli F, Proietti F, Cianfarani A, Garofalo F, Di Giuseppe M et al (2021) Suture and fixation of the transversalis fascia during robotic-assisted transabdominal preperitoneal hernia repair to prevent seroma formation after direct inguinal hernia repair. Surg Innov 28(3):284\u2013289 https:\/\/doi.org\/10.1177\/1553350620960976","journal-title":"Surg Innov"},{"key":"3623_CR5","doi-asserted-by":"publisher","unstructured":"Ng AY, Lin J, Ching SS, Lee J, Wong ASY (2020) Does primary closure of direct inguinal hernia defect during laparoscopic mesh repair reduce the risk of early recurrence? Hernia 24(5):1093\u20131098. https:\/\/doi.org\/10.1007\/s10029-020-02257-9","DOI":"10.1007\/s10029-020-02257-9"},{"issue":"4","key":"3623_CR6","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1007\/s10029-019-01903-1","volume":"23","author":"J Li","year":"2019","unstructured":"Li J, Gong W, Liu Q (2019) Intraoperative adjunctive techniques to reduce seroma formation in laparoscopic inguinal hernioplasty: a systematic review. Hernia 23(4):723\u2013731 https:\/\/doi.org\/10.1007\/s10029-019-01903-1","journal-title":"Hernia"},{"key":"3623_CR7","doi-asserted-by":"publisher","unstructured":"Ng TP, Loo BYK, Chia CLK (2023) Seroma-prevention strategies in minimally invasive inguinal hernia repair: a systematic review and meta-analysis. Int J Abdom Wall Hernia Surg 6(1). https:\/\/doi.org\/10.4103\/ijawhs.ijawhs_5_23","DOI":"10.4103\/ijawhs.ijawhs_5_23"},{"issue":"1","key":"3623_CR8","doi-asserted-by":"publisher","first-page":"e1426","DOI":"10.1590\/0102-672020180001e1426","volume":"32","author":"M Furtado","year":"2019","unstructured":"Furtado M, Claus CMP, Cavazzola LT, Malcher F, Bakonyi-Neto A, Saad-Hossne R (2019) Systemization of laparoscopic inguinal hernia repair (TAPP) based on a new anatomical concept: inverted Y and five triangles. Arq Bras Cir Dig 32(1):e1426 https:\/\/doi.org\/10.1590\/0102-672020180001e1426","journal-title":"Arq Bras Cir Dig"},{"issue":"3","key":"3623_CR9","doi-asserted-by":"publisher","first-page":"166","DOI":"10.5005\/jp-journals-10033-1587","volume":"16","author":"SS Singh","year":"2024","unstructured":"Singh SS, Ajay M, Rajyaguru (2024) Primary Closure of Direct Inguinal Hernia Defect in Laparoscopic Repair by Pre-tied Suture Loop Technique for Prevention of Seroma: A Prospective Cohort Study. World J Laparosc Surg 16(3):166\u2013168 https:\/\/doi.org\/10.5005\/jp-journals-10033-1587","journal-title":"World J Laparosc Surg"},{"issue":"1","key":"3623_CR10","doi-asserted-by":"publisher","first-page":"69","DOI":"10.4103\/jmas.jmas_391_21","volume":"19","author":"M Lodha","year":"2023","unstructured":"Lodha M, Meena SP, Parihar YK, Badkur M, Puranik AK, Kompally PV (2023) A newer method of seroma reduction by fenestration of pseudo-sac during laparoscopic repair of direct inguinal hernia: a randomised, controlled pilot study. J Minim Access Surg 19(1):69\u201373 https:\/\/doi.org\/10.4103\/jmas.jmas_391_21","journal-title":"J Minim Access Surg"},{"issue":"4","key":"3623_CR11","doi-asserted-by":"publisher","first-page":"622","DOI":"10.4103\/jmas.jmas_235_21","volume":"18","author":"J Abraham","year":"2022","unstructured":"Abraham J (2022) Suturing the lax pseudosac to Cooper\u2019s ligament to prevent seroma in endoscopic hernia repair: a new technique. J Minim Access Surg 18(4):622\u2013624 https:\/\/doi.org\/10.4103\/jmas.jmas_235_21","journal-title":"J Minim Access Surg"}],"container-title":["Hernia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10029-026-03623-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10029-026-03623-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10029-026-03623-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:02:08Z","timestamp":1773784928000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10029-026-03623-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3623"],"URL":"https:\/\/doi.org\/10.1007\/s10029-026-03623-9","relation":{},"ISSN":["1248-9204"],"issn-type":[{"value":"1248-9204","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"assertion":[{"value":"18 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by The Institute Research Ethics Committee (REC) with registration number (MS-142-2024).All participants were assigned informed written consent and could stop participating anytime.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declared that they have no competing that might bias the content of this work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"138"}}