Following laparoscopic TEP inguinal hernia repair, a patient develops scrotal swelling 48 hours post-operatively. Ultrasound confirms a serohematic fluid collection without active bleeding. What is this complication called and what is the initial management?

• A Wound haematoma; take back to theatre for evacuation
• B Pseudocyst of canal of Nuck; refer to radiologist for aspiration
• C Seroma; conservative management with scrotal support and analgesics ✓
• D Hematocele; urgent surgical evacuation required

Explanation

Post-laparoscopic hernia repair seroma is the most common early complication, resulting from obliteration of the hernia sac (not excised in laparoscopic repair) that fills with serous fluid. Ultrasound can confirm absence of recurrence. Management is conservative — scrotal support, NSAIDs, and reassurance. Most seromas resolve spontaneously within 6–8 weeks. Aspiration is not recommended as it risks introducing infection. Surgery is rarely needed. This differs from a true haematoma (needs monitoring) or wound infection. Seroma rates are higher with larger hernias where the sac is not removed.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.