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Robotic-Assisted Laparoscopic (rTAPP) Bilateral Inguinal Hernia Repair

David Lourié, MD, FACS, FASMBS
Huntington Memorial Hospital

1. Introduction

2. Surgical Approach and Placement of Ports

  1. Insert 8-mm Optical Trocar
  2. Insufflate the Abdomen
  3. Inject Marcaine for Ilioinguinal Nerve Block
  4. Insert 8-mm Lateral Trocars

3. Mesh Preparation

4. Dock Robot

5. Dissection

  1. Inspect Anatomy
  2. Dissect Peritoneal Flap Inferomedially
  3. Expose the Midline Pubic Symphysis
  4. Dissect Preperitoneal Flap Inferolaterally

6. Right Hernia Sac Dissection

  1. Develop a Groove Medial to the Iliac Vein
  2. Separate Peritoneal Sac from Cord Structures
  3. Parietalize Vas and Spermatic Vessels

7. Posterosuperior Peritoneal Dissection

  1. Nerve Identification

8. Lipoma of the Cord Dissction

9. Left Preperitoneal Flap Dissection

10. Left Hernia Sac Dissection

11. Obtain and Verify Critical View of the Myopectineal Orifice

12. Mesh Placement

13. Closure

14. Post-op Remarks