BEST OF VIDEO 3
Keyword(s): foreign body, nonabsorbable tacker, Occams razor TAPP repair, plug & patch repair, polyester mesh, polypropylene plug, recurrent inguinal hernia, transabdominal approach
SAGES Member Discussion
This video was accepted for presentation at the 2010 SAGES Scientific Session via a peer-review process- nice video, just wondering if it could have been attempted by extra-peritoneal approach.
- Nice video. TAP also allows for full examination of the abdomen for other causes of pain (ie. adhesion/erosion of the plug into bladder or colon, GYN problems and so on)
Good effort. Its usually difficult working in scarred tissue and I agree that a TAP may be more advantageous here than TEP- the clip is not clear. Nice commentery
Good demonstration of a difficult case. Signifies relevance of TAP in difficult cases.
Agreed, TAP made this a more manageable procedure but it could have been approached with a TEP method. Still, this is a relatively common problem and this video demonstrates a safe method of addressing it.
Nice case. I really like the apparent handling of the polyester mesh. I wonder how much pain she had postop. I would have been worried about using cautery to excise the prior mesh increasing the risk of nerve injury. I heard the doctor say that they use a minimum number of tacks, but it looked like they closed the peritoneal defect with the non-absorbable tacks also.
This could have been done with a TEP approach. I would have preferred suture closure of the peritoneum given the tacks were placed so close to the bladder. The tacks looked like absorbatacks, not titanium tacks.- This video is good.
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