Bilateral Laparoscopic Inguinal Hernia Repair with Mesh Using the Totally Extraperitoneal (TEP) Technique
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Procedure Outline
Table of Contents
- 1. Introduction
- 2. Preparation
- 3. Infraumbilical Incision
- 4. Access to the Preperitoneal Space and Placement of Ports
- 5. Visualization of the Public Tubercle
- 6. Following Cooper's Ligament Laterally Towards Hesselbach's Triangle
- 7. Direct Space Examination and Reduction of any Hernia
- 8. Femoral Space Examination and Reduction of any Hernia or Fat
- 9. Identification and Elevation of Epigastric Vessels and Dissection Laterally to the ASIS
- 10. Lateral-to-Medial Indirect Space Dissection and Reduction of any Hernia or Preperitoneal Fat
- 11. Repeat on the Right Side
- 12. Preparation of the Myopectineal Orifice for Flat Mesh Placement
- 13. Changing Gloves
- 14. Placement of the Mesh
- 15. Closure
- 16. Post-op Remarks
- Position the Patient
- Surgical Site and Scrotum Prep
- Draping and Setup
- Follow Cooper's Ligament Laterally Towards Hesselbach's Triangle
- Examine the Direct Space and Reduce any Hernia
- Examine the Femoral Space and Reduce any Hernia or Fat
- Identification and Elevation of Epigastric Vessels and Dissection Laterally to the ASIS
- Lateral-to-Medial Indirect Space Dissection and Reduction of any Hernia or Preperitoneal Fat
- Clearing the Cord and Vas Deferens of any Peritoneum
- Clearing the Left Cord and Vas Deferens of any Peritoneum
- Fixate with Tacks
- Desufflation Under Direct Visualization
