Usah Khrucharoen, Yen-Yi Juo, Yijun Chen, Erik Dutson. UCLA
While surgeons occasionally convert from a totally extraperitoneal (TEP) approach to a transabdominal preperitoneal (TAPP) during laparoscopic inguinal hernia repair due to inadvertent peritoneum violation, it is infrequent for surgeons to convert from TAPP to TEP, due to the perceived difficulty in maintaining preperitoneal work space after the abdomen has been entered. We hereby present a patient with right inguinal hernia and a history of prior prostatectomy, leading to a decision to adopt a TAPP approach in order to avoid the previously entered preperitoneal space. However, significant intraabdominal adhesion was encountered upon entering the abdomen. In this video, we demonstrate our technique in converting from TAPP to TEP, whereby the umbilical port was reintroduced into the preperitoneal space. Pneumoperitoneum was reversed and adequate preperitoneal work space could be maintained. Postoperative course was uneventful, and patient was discharged on the following day.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91892
Program Number: V352
Presentation Session: Video Loop Day 3
Presentation Type: VideoLoop