Endohernia surgery: our innovations
Chowbey, P.K. (2002) Endohernia surgery: our innovations. In: Congress of Endoscopic and Laparoscopic Surgeons of Asia, 2002 [ELSA 2002], 19-21 Sep 2002, Tokyo, Japan.
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Laparoscopic approach for hernia has evolved rapidly over the past decade. The two techniques which have gained wide support are the transabdominal preperitoneal (TAPP) and the total extraperitoneal (TEP) repair. TEP is our preferred technique and we have fairly large series to supper our views. This procedure is extremely cost effective as compared to other technique in term of overall expenditure and although technically demanding, it becomes an enjoyable experience once the surgeon comes out of the learning curve. We have further introduced certain innovations to overcome the procedures technical difficulties and simultaneously make the procedure even more cost effective. These include an indigenous glove finger balloon for creating the working space, rolling and fixing the mesh to 3/4th of its length with two chronic catqut sutures, anchoring the mesh to the pubic and Cooper's ligament with one or two spiral tacks or staples and finally unrolling the mesh on the floor i.e. on the peritoneal flap after releasing the catgut sutures holding the rolled mesh. This technique which we describe as the modified SGRH technique will be presented and discussed.
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