Use of Cyanoacrylate Glue as an Alternative for Peritoneal Defect Closure in Minimally Invasive Inguinal Hernia Repair by Tep Approach

Aims Laparoscopic approach to inguinal hernia has a great future as a gold standard' procedure given its advantages over the open approach. Regarding the TEP approach, one of the biggest 'fears' is repairing an accidental opening of the peritoneum in the surgery. An Endoloop can be used for closure, however, if the defect is too large it forces us to suture it. We present an alternative for closure of such holes. Methods A male patient with diagnosis of bilateral inguinal hernia who underwent repair by TEP approach. In the first surgical technique introducing the balloon to dissect the pre-peritoneal space in order to be able to approach the inguinal spaces, a very firm adherence of the peritoneum to the area of the vas deferens is observed, which when the balloon dissection is performed produces a laceration of the peritoneum and an important defect that must be repaired. Results Continued by dissecting and identifying the anatomical landmarks to determine the area of dissection and their location with respect to the hernial defect. The anatomical spaces are dissected and the hernial sac is freed from the rest of the structures and placed the mesh. Before going to the contralateral side, the orifice is closed with cyanoacrylate glue. It is not necessary to use sutures for this closure, checking its tightness and security in order to continue. Conclusions We believe that the use of cyanoacrylates for the closure of holes in the peritoneum during the TEP-approach can be a useful and efficient resource.