Pre-peritoneal Fat as a Guide to Extended View Total Extraperitoneal (eTEP) Repair for Inguinal Hernia

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Hernia Repair Techniques

Background:

• Pre-peritoneal space creation is critical in extra-peritoneal inguinal hernia repair.
• Lack of clear landmarks can lead to difficult dissections and peritoneal injury.
• This can compromise the surgical working space and increase operative risk.

Purpose of the Study:

• To describe a novel technique for pre-peritoneal space creation in extra-peritoneal inguinal hernia repair.
• To evaluate the safety and efficacy of this technique using patient data.
• To provide a reliable method for identifying the correct dissection plane.

Main Methods:

• A technique utilizing the fatty tissue of the median umbilical ligament and along the rectus muscle was employed.
• Data from 84 patients undergoing surgery between January 2021 and May 2023 were retrospectively analyzed.
• Patient demographics, hernia type, and perioperative complications were assessed.

Main Results:

• The described technique was applied in 84 patients.
• Two instances of peritoneal injury were noted.
• No other intraoperative complications were recorded, indicating a high safety profile.

Conclusions:

• The described technique for pre-peritoneal space creation is a safe and effective method for extra-peritoneal inguinal hernia repair.
• Utilizing the median umbilical ligament and rectus muscle fatty tissue provides reliable landmarks.
• This approach minimizes the risk of peritoneal injury and maintains adequate working space.