Abstract
Three principal approaches for laparoscopic herniorrhaphy are described. The most recent results are presented and discussed. The most popular current approach is the transabdominal pre-peritoneal prosthetic repair. This method involves laparoscopic access to the peritoneal cavity, incision of the peritoneum from within to access the pre-peritoneal plane, disposition of the hernial sac, placement of the mesh in the pre-peritoneal plane, and re-approximation of the peritoneal flap to provide a barrier between the mesh and the bowel. A second laparoscopic approach is the extraperitoneal operation. This involves a small incision below the umbilicus, tunnelling to develop the pre-peritoneal space without entering the peritoneum, disposition of the hernial sac, placement of mesh and closure. This approach is more difficult for the surgeon to learn compared with the transabdominal approach. The third approach - known as the intraperitoneal onlay mesh operation - is the easiest and fastest to perform but is also...
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