ArticleJournal of minimal access surgery
Trocar insertion in enhanced-view totally extra-peritoneal (eTEP) repair of inguinal hernias.
Article in Journal of minimal access surgery. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Intraoperative complications of robotic-assisted extended totally extraperitoneal (eTEP) ventral hernia retromuscular repairs with mesh: a systematic literature review and narrative synthesis.Journal of robotic surgery · 2024Pooled it
- A comparative study on optical trocar entry vs. balloon trocar entry in laparoscopic eTEP inguinal hernia repair - a randomised control trial.Hernia : the journal of hernias and abdominal wall surgery · 2025Trial
- Article
- Pre-peritoneal Fat as a Guide to Extended View Total Extraperitoneal (eTEP) Repair for Inguinal Hernia.Cureus · 2024Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe enhanced view totally extra-peritoneal (eTEP) repair is a useful modification of the classic TEP operation which offers a more panoramic view of the operative field with greater flexibility in port positioning. It can offer greater ease of surgery in large, irreducible or bilateral inguinal hernias due to its improved ergonomics. Misunderstanding the myo-fascial anatomy, incorrect positioning or sequence of trocar insertion can lead to inadvertent peritoneal injury with pneumoperitoneum, impeding the operating surgeon.
methodsWe describe our method for the surface marking of the semilunar and arcuate lines which guides the site of initial optic access. After blunt/balloon dissection of the pelvic extra-peritoneal space, the lateral trocar is inserted first to clear the peritoneum off the posterior aspect of arcuate line, allowing us to divide it near its medial attachment. The second working trocar is inserted at the umbilicus after visually confirming the extent of dissection. Additional trocars are inserted depending on bilaterality or size of the hernia.
resultsWe have operated 124 cases of bilateral inguinal hernia between April 2017 and February 2020, where we suffered peritoneal injury in only four cases, without leading to the conversion of the procedure. The widely dissected space with the division of the arcuate line further increased the ease of laying down a large prosthetic mesh.
conclusionThe exact sequence of trocar insertion and their positioning described by us improves ergonomics and ensures a safe division of the arcuate line with minimal risk of damage to underlying peritoneum.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.