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Anatomical pitfalls in the technique for total extra peritoneal laparoscopic repair for inguinal hernias
J P Faure1, C Doucet, Ph Rigouard
1Service Chirurgie Viscérale Digestive et Endocrinienne, Hôpital Jean Bernard, CHU Poitiers, rue de la Miletrie, BP 577, 86021, Poitiers cedex, France. j.p.faure@chu-poitiers.fr
Purpose:
The totally extraperitoneal laparoscopic approach for the treatment of inguinal hernia is a well-recognized technique with proven efficacy, low failure rate, and reduced post-operative pain. This laparoscopic technique is reputed to be a more difficult procedure to learn and practice than a laparoscopic trans-abdomino-pre-peritoneal procedure: we hope this is because many surgeons don't well know extra-peritoneal anatomy of groin. So we proposed a "step by step" anatomical analysis, with pitfalls to avoid, of a totally extraperitoneal laparoscopic approach for treatment of inguinal hernia.
Methods:
Our experience with totally extraperitoneal laparoscopic inguinal hernia repair with regard to the morphology of the inguinal-femoral region concerns 23 cadaver dissection and more than 400 surgical procedures, now permits clarification of a surgical technique that has hitherto not been well known.
Conclusion:
Photographic representations of surgical views are displayed, and detailed descriptions applicable to anatomical structures are presented.