Shenoy K Ganesh
Department of Minimal Access, GI and Bariatric Surgery, Fortis Hospital, Bengaluru, Karnataka, India.
J Minim Access Surg. 2025 Jan 1;21(1):97-99. doi: 10.4103/jmas.jmas_243_23. Epub 2023 Sep 20.
The advantages of enhanced view totally extraperitoneal (eTEP) over TEP approach are well established in large inguinoscrotal, recurrent inguinal, patients with short pubis to umbilicus distance and in obese patients. Irreducible inguinoscrotal hernias (IISHs) and giant inguinal hernias (GIHs) pose a great challenge. GIHs are hernias which extend below the midpoint of the inner thigh with the patient in the standing position. Majority of these hernias are managed by open, hybrid or by transabdominal pre-peritoneal (TAPP) approach. TAPP was considered the optimal minimally invasive approach for these hernias as it provides a large working space and reduction of contents under vision. My practice of eTEP has been limited to IISH and GIH. I would like to share some technical tips to manage these cases by eTEP approach.
在大型腹股沟阴囊疝、复发性腹股沟疝、耻骨至脐距离短的患者以及肥胖患者中，完全腹膜外强化术（eTEP）相对于TEP手术的优势已得到充分证实。不可复性腹股沟阴囊疝（IISH）和巨大腹股沟疝（GIH）带来了巨大挑战。GIH是指患者站立时疝囊延伸至大腿内侧中点以下的疝。这些疝大多数通过开放手术、杂交手术或经腹腹膜前（TAPP）手术进行处理。TAPP被认为是治疗这些疝的最佳微创方法，因为它提供了较大的操作空间，并能在直视下还纳内容物。我对eTEP的应用仅限于IISH和GIH。我想分享一些通过eTEP方法处理这些病例的技术要点。
