laparoscopic inguinal hernia repair (TEP).mp4

Presentation of one surgeon's technique for repair of inguinal (groin) hernia by laparoscopy without entering the abdominal cavity (total extraperitoneal "TEP" repair). Indications, advantages, disadvantages and risks are described. Diagrams demonstrate the anatomy and the procedure itself and are integrated with video clips of the actual surgery. The presentation is designed to be instructive for both non-medical viewers and health care professionals.

Category:

Science & Technology

Tags:

• hernia
• inguinal
• laparoscopy
• laparoscopic
• repair
• extraperitoneal
• TEP

[AlbertoBdeQ]

Congratulations for this fantastic video Dr. Clarke. I would like to ask in relation to the mesh used, what are de pros and cons of using a non-slit mesh over the whole area and parietalizing the cord vs. using a slit mesh with a hole to let the elements of the cord through. Which of both procedures is anatomically most convienient? Does any have higher risk of damaging the cord structures because of contact with the mesh? Thank you very much in advance

[jmclarke2]

@AlbertoBdeQ Briefly, the slit technique is easier to do, since it does not require the extensive parietalization needed to keep peritoneum from getting under the inferior edge of an "onlay" patch, which may cause a recurrence. But the slit may cause an increase in testicular swelling, in my experience. I rarely use the slit now. Thanks for your comments.

John

[BRW1249]

Been dealing with my procedure since 3/4/11. Sent to pain management with no relief from discomfort and continuing pain. No one seems now to want to help resolve this, so I have to live with it. Anyone planning on having this procedure better talk seriously with thier surgeon. It's not any comfort to know once they're done with you, you're on your own!

[jmclarke2]

@BRW1249 This is very rare with the laparoscopic technique, although a significant incidence of chronic pain is reported with the "open" or non-laparoscopic methods. This fact is one of the big advantages of laparoscopic hernia repair. It's unfortunate that you got this result. There are some specialists who can sometimes help. I have little experience dealing with postoperative pain, since it has rarely occurred in my own patients.

John

[adrianteotube]

Fanstastic video Dr Clarke

[jmclarke2]

@adrianteotube Thank you. It was a bit hard trying to make it technical enough for other docs who want to see it, yet understandable for the non-medical people. I appreciate your reply.

John

[ctberg100]

Excellent video, Dr. Clarke. Your passion for your work is evident (at least to me), and the selection of the accompanying music to the video is balsam for the soul.

I had this procedure done 5 days ago, and I am up and going again. Thank you,

Carsen Tannberg, DC., ND

[MrAzrt]

thank you very much Dr Clarke, it 's very instructif

[BRW1249]

Had this done on 3/4/11. Wondered what the "staples/tacks looked like!! I can feel where they were attached. My doc kept me off work for 6 full weeks after the procedure. I suppose the post surgical nerve and other pains will subside eventually.

Worst part was the bladder foley catheter insertion and removal caused serious pain for a couple of days due to irritation. Guess they forgot to lube it.....