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Minimally Invasive Surgical Techniques for Inguinal Hernia Repair: The Extended-View Totally Extraperitoneal Approach (eTEP)

  • Jorge Daes
Chapter

Abstract

The extended-view totally extraperitoneal (eTEP) technique has evolved as a way to compensate for the disadvantages of working within a limited space. The eTEP technique is based on a better understanding of the abdominal wall anatomy and the notion that the extraperitoneal space is limitless once the confluence of the arcuate arch and semilunar line is taken down. The eTEP repair of inguinal hernias facilitates rapid and easy creation of the extraperitoneal space, a larger surgical field, a flexible port setup, tolerance to pneumoperitoneum, and good ergonomics. Overall, a sound extraperitoneal space for inguinal hernia repair that is compliant with the concept of the critical view of the myopectineal orifice is easier to establish. Many procedures have branched out from the eTEP concept, including eTEP lumbar neurectomy, eTEP lumbar hernia repair, the eTEP Rives-Stoppa technique, and eTEP transverse abdominis muscle release (TAR) for ventral hernia repair.

Keywords

Extended-view TEP Inguinal hernia Laparoscopic Hernia repair eTEP Enhanced-view TEP Extraperitoneal technique 

Supplementary material

Video 33.1

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Video 33.2

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References

  1. 1.
  2. 2.
    Schmedt CG, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc. 2005;19:188–99.  https://doi.org/10.1007/s00464-004-9126-0.CrossRefPubMedGoogle Scholar
  3. 3.
    McCormack K, Scott NW, Go PM, et al. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2003;(1):CD001785.Google Scholar
  4. 4.
    Daes J. Reparo laparoscopico de la hernia inguinal. Experiencia de la Unidad de Laparoscopia. Clinica Bautista, Barranquilla, Colombia. Rev Colomb Circ. 1999;14:97–103.Google Scholar
  5. 5.
    Wake BL, McCormack K, Fraser C, et al. Transabdominal preperitoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2005;(1):CD004703.  https://doi.org/10.1089/lap.2008.0212.CrossRefGoogle Scholar
  6. 6.
    Leibl BJ, Jager C, Kraft B, et al. Laparoscopic hernia repair—TAPP or/and TEP? Langenbecks Arch Surg. 2005;390:77–8.CrossRefGoogle Scholar
  7. 7.
    Ferzly G, Sayad P, Vasisht B. The feasibility of laparoscopic extraperitoneal hernia repair under local anesthesia. Surg Endosc. 1999;13:588–90.CrossRefGoogle Scholar
  8. 8.
    Ismail M, Garg P. Laparoscopic inguinal total extraperitoneal hernia repair under spinal anesthesia without mesh fixation in 1,220 hernia repairs. Hernia. 2009;13:115–9.CrossRefGoogle Scholar
  9. 9.
    Daes J. The enhanced view-totally extraperitoneal technique for repair of inguinal hernia. Surg Endosc. 2012;26:1187–8.CrossRefGoogle Scholar
  10. 10.
    Daes J. Endoscopic repair of large inguinoscrotal hernias: management of the distal sac to avoid seroma formation. Hernia. 2014;18:119–22.CrossRefGoogle Scholar
  11. 11.
    Daes J. The extended view of totally extraperitoneal e-TEP technique for inguinal hernia repair. In: Novinsky YW, editor. Hernia surgery: current principles, vol. 2016. New York: Springer; 2016. p. 467–72.Google Scholar
  12. 12.
    Daes J, Felix E. Critical view of the myopectineal orifice. Ann Surg. 2016;266(1):e1–2.CrossRefGoogle Scholar

Copyright information

© Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2019

Authors and Affiliations

  • Jorge Daes
    • 1
  1. 1.Minimally Invasive Surgery, Clínica PortoazulBarranquillaColombia

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