A hernia can pose risks as the structures within your abdomen including your intestines can become trapped. Instruments in tep technique.
The most important first step for successful completion of total extraperitoneal tep hernia repair is correct entry into the preperitoneal space.
Tep inguinal hernia repair steps. Laparoscopic inguinal hernia repair tep what is an inguinal hernia. Surgical anatomy a thorough knowledge of the extraperitoneal inguinal anatomy is required to avoid complications. In some cases short clips of other patients are inserted as intermezzo for better understanding.
It offers a teaching guide especially to surgical trainees explaining the. Laparoscopic totally extraperitoneal tep inguinal hernia repair is an effective minimally invasive method for treating hernias that avoids entry into the abdomen. The principle advantages of this technique over open surgery are.
The choice of approach to the laparoscopic repair of inguinal hernia is controversial. A detailed description of the procedure is presented focusing on seven key steps. Additionally and in order to create more preperitoneal space we will use a pdb balloon trocar and subsequently a 12 mm btt structural trocar.
This video is a step by step approach to the technique of total extra peritoneal repair tep of a left inguinal hernia. An inguinal hernia occurs at the inguinal canal a thin passage where blood vessels pass through the abdominal wall. Laparoscopic inguinal hernia repair.
This video describes our technique for a totally extraperitoneal endoscopic inguinal hernia repair or tep procedure in a male patient with a right inguinal hernia. The technique consists of 10 consecutive steps of which steps 1 2 4 8 and 10 are more basic and steps 3 5 6 7 and 9 more advanced. This video shows how inguinal hernias form and how they are treated.
The totally extraperitoneal repair tep is a keyhole technique for inguinal hernia repair. Tapp requires access to the peritoneal cavity with placement of a mesh through a peritoneal incision. The most commonly used laparoscopic techniques or inguinal hernia repair are transabdominal preperitoneal tapp repair and totally extraperitoneal tep repair.
Chapter 15 total extraperitoneal tep hernia repair patricia sylla david w. An inguinal hernia is a bulging of the intestine through a defect or weak spot in the wall of the lower abdomen. With this technique hernias are repaired using a piece of mesh which is placed behind the muscle of the abdominal wall.
Its indications have developed and broadened over time to encompass almost the whole spectrum of groin hernias. The mesh and the fixation method used will be dealt with in other chapters. Since laparoscopic inguinal hernia repair was first reported by ger and colleagues in 1990 the operation has been refined into an attractive alternative to open hernia repair for many patients and surgeons although few would argue that laparoscopic inguinal hernia repair can be performed with excellent results controversy abounds because the results of open mesh repairs are.