Laparoscopic E-Tep in Giant Type I Direct Inguinal Hernia

Case Profile 68 yrs old, Male presented with complaints of Large right sided Inguino-Scrotal swelling since 3 yrs. Swelling was intermittent, partially reducible and associated with a dragging type of Pain. No other co-morbidities. CT-scan: Tanaka Index – 20% Plan Laparoscopic E-TEP hernia repair. Procedure Supine Position under General Anesthesia. Hernia contents reduced under anesthesia. Ports Enhanced Pre-Peritoneal space created by cutting Posterior Rectus Sheath from Arcuate line. Space of Retzius & Bogros dissected. Spermatic Cord dissected. Hernial sac dissected and separated from Pseudo sac. Excision of Pseudo sac done. Hernial Defect sutured with Non-absorbable barbed suture 15 × 12 cm Polypropylene mesh placed obtaining adequate coverage of Myopectineal orifice of Fruchaud. Hemostasis confirmed. Pneumo pre-peritoneum deflated. Port sites closed. Dressing and strapping done. Post operative period uneventful. Discharged on post op day 4.