Removal of mesh plug and TEP repair of a recurrent left inguinal hernia in a 72-year-old man
Epublication WebSurg.com, Jun 2007;07(06). URL: http://websurg.com/doi/vd01en2137
This video demonstrates in great detail the laparoscopic TEP approach to recurrent hernia. The previously placed mesh plug is carefully dissected and removed. The preperitoneal space is thus created in order to place a mesh in the correct position. This video is suitable for experienced laparoscopic hernia surgeons. The author begins the dissection lateral to the inferior epigastric vessels, then uses sharp dissection to take down the adhesions. This step requires caution because of the proximity of major vessels. The author then continues with sharp and blunt dissection to further develop the lateral peritoneal space. A few clean sweeps of the scissors or blunt forceps downward make adequate space lateral to the inferior epigastric vessels for mesh placement.