Percutaneous endoscopic external ring hernioplasty using Dundee inguinal canal retractor

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Hernia Repair Techniques

Background:

• Inguinal hernias are common surgical conditions.
• Conventional open mesh repair is a standard treatment.
• Minimally invasive techniques aim to improve patient outcomes.

Purpose of the Study:

• To introduce and evaluate the percutaneous endoscopic external ring (PEER) hernioplasty.
• To assess the feasibility, safety, and efficacy of the PEER technique.
• To compare PEER hernioplasty with conventional open repair.

Main Methods:

• The PEER hernioplasty involves a two-stage procedure: an initial open phase with a small incision and dissection, followed by an endoscopic repair.
• An endoscopic approach is utilized after inserting a retractor through the external ring.
• Tension-free mesh repair (Lichtenstein or mesh plug) is performed to close the defect.

Main Results:

• PEER hernioplasty is an easily learned, safe, and cost-effective procedure.
• It offers benefits of minimal access surgery, including improved patient recovery and earlier return to work.
• The surgery can be performed as a day case under local or regional anesthesia.

Conclusions:

• PEER hernioplasty represents a novel, minimally invasive anterior approach to inguinal hernia repair.
• The technique is feasible, safe, and cost-effective, providing advantages of minimal access surgery.
• It offers a familiar anatomic approach for general surgeons, facilitating adoption.