Simulation Education: For Tapp and TEP Laparoscopic Inguinal Hernia Repair
We have previously described the McGill Laparoscopic Inguinal Hernia Simulator (MLIHS), which can be used to perform both transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repairs. In addition, we developed the Global Operative Assessm
Pntaloon Inguinal Hernia
Image obtained during Laparoscopic Hernioraphy. This illustrates the TAP view of a left direct (black arrow) and indirect hernia (White arrow) in a man. Omentum is incarcerated in direct hernia.
Sagittal view of extraperitoneal dissection
Sagittal view of extraperitoneal dissection. A space is developed between peritoneum and abdominal wall. Note that the bladder is mobilized downward.
Closing peritoneal flap over the mesh with staples
Closing peritoneal flap over the mesh with staples.
Palpate the head of the stapler/tacking device
Surgeon using nondominant (left) hand to palpate the head of the stapler/tacking device through the anterior abdominal wall, thus verifying stapler/tacking device position relative to external landmarks and providing counterpressure.