A Minimally Invasive Approach For Treating Postoperative Seromas After Incisional Hernia Repair

BACKGROUND The most frequent wound complication following repair of large incisional hernias is seroma formation, especially when the use of a mesh onlay requires extensive subcutaneous undermining. Treatment options for postoperative seromas include observation for spontaneous resolution, percutaneous aspiration, closed suction drainage, abdominal binders, and sclerosant. METHODS A novel technique for treating persistent postoperative seromas is presented herein. This technique involves a 3-puncture minimally invasive approach that can be performed in an outpatient setting. Evacuation of serous fluid and fibrinous debris is followed by argon beam scarification of the seroma cavity lining. Talc slurry is then introduced into the cavity. Three patients have been treated with this technique. RESULTS All 3 patients had successful ablation of seromas that had persisted despite standard treatment modalities. CONCLUSION A minimally invasive approach is a reasonable and safe alternative for treating persistent postoperative seromas.