Transballoon trocar insertion during preperitoneal hernia repair

Area of Science:

• Minimally Invasive Surgery
• Surgical Techniques
• Hernia Repair

Background:

• Laparoscopic preperitoneal hernia repair (TEP) presents challenges with trocar insertion due to limited preperitoneal space.
• Traditional trocar insertion can be difficult compared to transabdominal approaches.

Purpose of the Study:

• To describe a novel technique for facilitating trocar insertion during TEP.
• To improve the ease and efficiency of laparoscopic preperitoneal hernia repair.

Main Methods:

• Insertion of surgical trocars directly into the balloon used for preperitoneal space dissection.
• Placement of a 5-mm trocar, often followed by a second trocar, without significant balloon deflation.
• Removal of the balloon with trocars in situ, followed by cannula placement and repair initiation.

Main Results:

• Direct trocar insertion into the dissection balloon simplifies the process.
• The technique allows for secure placement of multiple trocars.
• Balloon removal with trocars in place enables efficient initiation of the hernia repair.

Conclusions:

• This method offers a straightforward solution to trocar insertion challenges in TEP.
• The technique enhances the feasibility and potentially reduces the difficulty of laparoscopic preperitoneal hernia repair.