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Updated: May 23, 2025
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Visual course of anatomical landmarks around the internal inguinal ring as a guide for horizon adjustment in
Kentaro Shinohara1, Takuya Saito2, Kohei Yasui1
1Division of Gastroenterological Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.
Purpose:
During laparoscopic inguinal hernia repair, the inferior epigastric vessels (IEVs), vas deferens, and spermatic vessels are often used as landmarks for horizon adjustment during camera navigation. The present study investigated the visual angle of landmarks around the internal inguinal ring using recorded video clips.
Methods:
The angle of the IEVs, vas deferens, spermatic vessels, and the degree of lateral tilt of the scope were measured using a video clip. The angle of the median line of the vas deferens and spermatic vessels (MVS) was also calculated.
Results:
Between 2018 and 2022, 70 inguinal hernia lesions underwent robot-assisted inguinal hernia repair. Under adjustment according to lateral tilt of the scope, the mean angles of the IEVs and MVS were 14.1° laterally (SD = 15.9°) and -1.5° medially (SD = 15.8°), respectively.
Conclusion:
The IEVs and MVS do not always adopt an absolutely vertical course, and some structures run obliquely. The angles of the IEVs and MVS should, therefore, be confirmed at the beginning of the operation to guide horizon adjustment.
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