Hernia – Sanjay Gupta

e TEP- Rives Stoppa for primary ventral hernia by three port technique

Suggested Reading

Ganesh et al. “Modified Three-Port Technique” of Extended Totally Extra Peritoneal-Rives Stoppa (eTEP-RS) Repair for Midline Ventral Hernias. Indian J Surg (2023)

eTEP (Extended view-Total Extra Peritoneal) repair of inguinal hernia

Compared to TEP, eTEP provides more working space and better visualisation of anatomical planes. It also obviates the need of blunt/blind dissection.

Suggested Reading

Daes J. The enhanced view- totally extraperitoneal technique for repair of inguinal hernia. Surg Endosc 2012; 26:1187-88

e TEP for direct inguinal hernia (Left)

Inadvertent peritoneal rents can be easily dealt in eTEP as it provides more working space as compared to TEP

Endoscopic enhanced-view totally extraperitoneal (eTEP) retrorectus approach for epigastric hernia

Offers better anatomical repair and is associated with less postoperative pain.

Suggested Reading

Belyansky I, Daes J, Radu VG, Balasubramanian R, Reza Zahiri H, Weltz AS, Sibia US, Park A, Novitsky Y. A novel approach using the enhanced-view totally extraperitoneal (eTEP) technique for laparoscopic retromuscular hernia repair. Surg Endosc. 2018 Mar;32(3):1525-1532

eTEP retro-rectus repair for para umblical hernia

More cost effective and provides better anatomical repair

Subcutaneous On-lay Laparoscopic Approach (SCOLA)

A safe and effective technique for repair of diastasis of the rectus abdominis muscles and associated small hernia of anterior abdominal wall.

Suggested reading

Claus CMP, Malcher F, Cavazzola It, et al. Subcutaneous Onlay Laparoscopic Approach (SCOLA) for ventral hernia and rectus abdominis diastasis repair: technical description and initial results. Brazilian archives of digestive surgery 2018; 31:e1399.

Laparoscopic cholecystectomy with incisional hernia repair

Transabdominal retromascular (TARM) with bilateral transversus abdominis release (TAR) for M2 (EHS) incisional hernia

Transabdominal retromuscular repair

Left sided, L2-L3 (EHS) incisional hernia

eTEP for bilateral inguinal hernia (L>>R)

In obese, and in patients with narrow pelvis, eTEP should be preferred approach

Trans-abdominal pre peritoneal patch plasty (TAPP)

Compared to TEP, TAPP offers similar outcome. If performed properly, both techniques are safe and effective.

Bochdalek hernia in an adult

A developmental defect in the postero-lateral diaphragm leading to herniation of abdominal contents into thoracic cavity. Commonly seen in paediatric age group but rarely in adults.