V-028 Use of Articulated Instruments in Extraperitoneal Abdominal Wall Surgery

Abstract

Introduction One of the limitations in extraperitoneal abdominal wall surgery is the reduced range of movements of conventional instruments. The aim of this video was to show the advantages of articulated instruments. Case presentation The first case was a laparoscopic totally extraperitoneal (TEP) inguinal hernia repair of a direct bilateral hernia in a male patient. In this intervention the articulated grasper assisted with the isolation of the hernia sac and allowed to modify the direction of the traction during the dissection. The second case was an extended totally extraperitoneal (eTEP) repair of a M3W2 incisional hernia associated to rectus diastasis in a female patient. The articulated instrument gave an increased traction adapted to the surface of the posterior rectus sheath and marked the limits for the section with the scissors. Conclusion The articulated instruments allowed an increased mobility in the extraperitoneal field. Note: the articulated instruments were manufactured by IMM, Mannheim, Germany.