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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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Updated: Jul 28, 2026

Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
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Percutaneous endoscopic external ring (PEER) hernioplasty

S T Ko1, M Airan, T Frank

  • 1Department of Surgery, Finch University of Health Sciences/The Chicago Medical School at Mount Sinai Hospital Medical Center, Chicago, IL, USA.

Surgical Endoscopy
|June 1, 1996
PubMed
Summary

Percutaneous endoscopic external ring (PEER) hernioplasty offers a less invasive and cost-effective approach for primary hernia repair. This pilot study shows PEER hernioplasty is effective with low complication rates.

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Area of Science:

  • Surgical Innovation
  • Minimally Invasive Surgery
  • Hernia Repair Techniques

Background:

  • Conventional and laparoscopic methods are standard for tension-free hernia repair.
  • There is a need for less invasive and more cost-effective surgical options.
  • The external inguinal ring is a key anatomical landmark in hernia repair.

Purpose of the Study:

  • To evaluate the efficacy and safety of percutaneous endoscopic external ring (PEER) hernioplasty.
  • To compare PEER hernioplasty with conventional and laparoscopic techniques.
  • To determine if PEER hernioplasty is a viable alternative for primary hernia repair.

Main Methods:

  • A pilot study involving 48 patients (60 primary hernias) treated between January 1993 and December 1994.
  • PEER hernioplasty procedure involves a small incision for sac excision and endoscopic mesh placement.
  • Median follow-up was 12 months (range 5-22 months).

Main Results:

  • All patients except one were discharged within 24 hours, resuming normal activity within 2-3 weeks.
  • Low complication rate: two scrotal hematomas and one inguinal seroma.
  • Only one recurrence in a single patient observed during follow-up.

Conclusions:

  • PEER hernioplasty is an effective method for primary hernia repair.
  • The technique is less invasive than conventional open surgery.
  • PEER hernioplasty is both less invasive and more cost-effective than laparoscopic approaches.