monthly focus

surgical intervention video

Dr. Salvador Morales-Conde presents the clinical case of a 59-year old female patient managed for an incisional hernia with a 6-7cm sac in the left lower quadrant. The patient’s history included a left iliac fossa laparotomy to control bleeding caused by an epigastric artery injury following a laparoscopic appendectomy. The patient was placed in a Trendelenburg position. An optical port and two 5mm operating ports were inserted on the right lateral side of the abdomen. Peritoneal dissection was performed to expose anatomical landmarks including pubic bone, iliac crest, and iliac vessels for proper mesh fixation. The defect of the abdominal wall was closed using a continuous suture. A trimmed mesh (Parietex™ Composite Mesh) was inserted and fixed with tackers to Cooper’s ligament, to the iliac crest, and to the abdominal wall to sufficiently cover the sutured defect. Finally, the preperitoneal flap was fixed on the mesh to prevent intestines from getting into the mesh gap. 

Left iliac fossa incisional hernia: live laparoscopic repair

Послеоперационной грыжи в левой подвздошной ямке: лапароскопическая пластика в режиме реального времени

Cure de hernie d’éventration de la fosse iliaque gauche par approche laparoscopique : chirurgie live

We present the clinical case of a 57-year old male patient managed for a bilateral reducible inguinal hernia. The patient’s history included a right inguinal hernia repair in his childhood. A first port was inserted 1cm above the umbilicus and two 5mm ports were placed 7cm away from the umbilicus on the right and left side. Peritoneal dissection starts with a horizontal incision and parietalization is performed carefully to avoid injury to the vessels and deferent duct. After the myopectineal orifice has been sufficiently exposed, polypropylene meshes (Parietene™) trimmed to a 13 by 12cm size are inserted into the preperitoneal cavity and fixed using absorbable tacks. Finally, the meshes are fully covered using peritoneal flaps.

Laparoscopic TAPP approach to bilateral reducible inguinal hernia: live interactive procedure

Intervention interactive live : voie d’abord transabdominale prépéritonéale (TAPP) laparoscopique pour hernie inguinale bilatérale réductible

Лапароскопическая TAPP пластика двусторонней паховой грыжи: интерактивная LIVE процедура

Laparoscopic total extraperitoneal (TEP) repair for the management of inguinal hernias has become increasingly popular since its introduction. Laparoscopic TEP repair can be performed safely with fewer perioperative complications, less recurrence, and a shorter hospital stay. In this live interactive video, Dr. Bernard Dallemagne presents a case of bilateral hernia repair using a polypropylene mesh without fixation. Authors do not not have any conflicts of interest or financial ties to disclose. 

Laparoscopic TEP bilateral inguinal hernia repair: a live interactive procedure

Intervention interactive live : traitement d’une hernie inguinale bilatérale par voie d’abord laparoscopique totalement extrapéritonéale (TEP)

Лапароскопическая TEP пластика двусторонней паховой грыжи: интерактивная LIVE процедура

We present the clinical case of a 45-year old male patient managed for a right direct inguinal hernia. The patient’s history included a former approach for right inguinal hernia in his childhood and a laparoscopic left inguinal hernia repair. A first port was inserted below the umbilicus and access to the pubic bone was gained on the midline without using balloon. In this case, dissection of adhesions related to the previous operation was required. Attempts were made to identify anatomical landmarks after insertion of 5mm ports. The direct hernia content was dissected and reduced with blunt dissection. Once anatomical landmarks including pubic symphysis, Cooper’s ligament, epigastric vessels, spermatic cord, and psoas muscle were identified, a trimmed polypropylene mesh was inserted and the myopectineal orifice was sufficiently covered without fixation. Finally, the preperitoneal cavity was desufflated to complete the procedure.

Laparoscopic TEP unilateral inguinal hernia repair: a live interactive procedure

Intervention interactive live : traitement d’une hernie inguinale unilatérale par voie d’abord laparoscopique totalement extrapéritonéale (TEP)

Лапароскопическая ТЕР пластика паховой грыжи: интерактивная LIVE процедура

Spigelian hernia is a rare condition and it is difficult to diagnose it clinically. It has been estimated to account for 0.12% of abdominal wall hernias. The hernia ring is a well-defined defect in the transversus abdominis aponeurosis. The hernia sac, surrounded with extraperitoneal adipose tissue, often lies interparietally passing through the transversus abdominis and the internal oblique muscle aponeuroses and then spreading out beneath the intact aponeurosis of the external oblique muscle. The laparoscopic repair is well-established. Most authors use a transperitoneal approach either by placing the mesh in an intraperitoneal position or by raising the peritoneal flap and placing the mesh in the extraperitoneal space. In this video, we demonstrate the laparoscopic repair of a Spigelian hernia through the transabdominal preperitoneal (TAPP) placement of a composite mesh.

Laparoscopic Spigelian hernia repair

Cure de hernie ventrale latérale (hernie de Spiegel) par voie d’abord laparoscopique

Грыжа спигелиевой линии

Worldwide, more than 20 million patients undergo groin hernia repair annually. The main objective of the Transabdominal Preperitoneal (TAPP) repair technique is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, which are the most frequent problems following groin hernia repair. In this instructional video, Dr. HA Mercoli, MD presents a case of recurrent inguinal hernia, first describing the anatomy of the groin area and then presenting the key steps of Transabdominal Preperitoneal repair (TAPP) repair technique. 

Laparoscopic TAPP repair for recurrent inguinal hernia

Лапароскопическая ТАРР пластика по поводу рецидивирующей паховой грыжи

Cure de hernie inguinale chronique récidivante par approche laparoscopique : technique TAPP

video lecture

Лапароскопическая паховая герниопластика



In this authoritative lecture, Dr. Narayanan covers laparoscopic incisional and ventral hernia repair.

Laparoscopic incisional and ventral hernia repair

Traitement d’une hernie ventrale et d’éventration par approche laparoscopique

Prise en charge d’une hernie étranglée

Лечение ущемлённой грыжи

In this authoritative lecture, Dr. D'Urso focuses on the management of strangulated hernia.

Management of strangulated hernia

Classification et anatomie de la région inguinale

In this authoritative lecture, Dr. Narayanan looks into classification and anatomy of the inguinal region. Dr. Narayanan, MBBS, MS, FRCS does not have any conflicts of interest or financial ties to disclose.

Classification and anatomy of the inguinal region

Классификация и анатомия пахового треугольника

Cure de hernie ventrale par approche laparoscopique : fixation de prothèse chirurgicale

Фиксация сетчатого протеза при лапароскопической вентральной герниопластики

In this authoritative lecture, Dr. Morales-Conde focuses on mesh fixation for laparoscopic ventral hernia repair.

Mesh fixation for laparoscopic ventral hernia repair

In this authoritative lecture, Professor Salvador Morales-Conde focuses on seroma avoidance and management in inguinal and ventral hernia repairs. Professor Morales-Conde does not have any conflicts of interest or financial ties to disclose.

Focus on abdominal wall hernia repair surgery