Blunt preperitoneal finger dissection during extraperitoneal laparoscopic inguinal hernia repair: an effective alternative to instrumental techniques.

Extraperitoneal laparoscopic inguinal hernia repair is a technically demanding procedure that nevertheless has significant advantages over the other types of laparoscopic inguinal hernia repairs. One of the difficulties inherent to the procedure is the establishment of an adequate working space between the abdominal wall and the peritoneum. A quick and efficient method is reported here that was used in 15 consecutive patients. The method provides wide exposure without the use of any sophisticated equipment or the need for a significant learning curve. Exposure of the preperitoneal space with the dissection technique described simplifies a difficult first step and makes the extraperitoneal repair an easier undertaking.