Lecture on TAPP Inguinal Hernia Surgery: A Specialized Approach by Dr. R.K. Mishra at WLTI, USA скачать в хорошем качестве

Lecture on TAPP Inguinal Hernia Surgery: A Specialized Approach by Dr. R.K. Mishra at WLTI, USA

Transabdominal Preperitoneal (TAPP) repair is one of the most widely used laparoscopic techniques for inguinal hernia repair. Dr. R.K. Mishra, a globally renowned laparoscopic and robotic surgeon, has pioneered advanced techniques in minimal access surgery, making hernia repair safer and more effective. His expertise in TAPP surgery has trained thousands of surgeons worldwide, ensuring optimal patient outcomes. Understanding TAPP Inguinal Hernia Surgery TAPP is a laparoscopic approach that allows direct visualization of the hernia defect, facilitating anatomic mesh placement and reducing recurrence rates. It is performed under general anesthesia and involves three small incisions to access the peritoneal cavity. Step-by-Step Surgical Technique by Dr. R.K. Mishra 1. Port Placement and Peritoneal Access • A supraumbilical port is used as the camera port. • Two ipsilateral 5mm working ports are placed in the lower abdomen. • CO₂ insufflation is used to create a pneumoperitoneum. 2. Peritoneal Incision and Hernia Dissection • A transverse peritoneal incision is made 2-3 cm above the hernia defect. • The preperitoneal space is dissected to expose the myopectineal orifice. • The hernia sac is carefully reduced, ensuring complete separation from the cord structures (in indirect hernias) or the bladder (in direct hernias). 3. Mesh Placement and Fixation • A polypropylene or composite mesh (typically 10x15 cm) is placed to cover the hernia defect. • The mesh is positioned to cover the medial, lateral, and femoral spaces, ensuring full defect coverage. • Mesh fixation is performed using tackers or glue to prevent displacement. 4. Peritoneal Closure • The peritoneum is sutured or tacked to prevent direct mesh contact with bowel loops, reducing adhesion risks. • The pneumoperitoneum is released, and ports are removed under vision. Advantages of TAPP Repair ✅ Minimally invasive approach with faster recovery. ✅ Direct visualization of the hernia defect and surrounding anatomy. ✅ Lower recurrence rates compared to open hernia repair. ✅ Reduced postoperative pain and quicker return to normal activities. Dr. R.K. Mishra’s Tips & Tricks for TAPP Success ✔️ Adequate dissection of the preperitoneal space is key to avoiding mesh migration. ✔️ Careful handling of cord structures prevents nerve injury and chronic pain. ✔️ Tension-free peritoneal closure minimizes the risk of mesh exposure. Conclusion Dr. R.K. Mishra’s expertise in laparoscopic hernia surgery has significantly advanced the field of minimal access surgery. His meticulous approach to TAPP inguinal hernia repair ensures better outcomes, reduced complications, and improved patient satisfaction. With his vast experience and commitment to surgical education, he continues to train surgeons worldwide, shaping the future of laparoscopic hernia repair. Contact us World Laparoscopy Hospital Cyber City, Gurugram NCR Delhi, India World Laparoscopy Training Institute Bld.No: 27, DHCC, Dubai, UAE World Laparoscopy Training Institute 5401 S Kirkman Rd Suite 340 Orlando, FL 32819, USA