Managing the distal hernia sac effectively reduces seroma after laparoscopic repair of large indirect inguinal hernias.

• Seroma occurrence was significantly lower in midline transection with lateral fixation (4.69%) compared to transection and abandonment (18.03%).
• Hospital stay was longer for abandonment group (6 days) versus complete dissection or midline strategies (5 days).

Consider this approach for better seroma outcomes without raising complication risks.

• Operating time was longer for complete dissection (94 min) compared to midline and abandonment techniques (80-94 min).