Description

In this comprehensive surgical video, Prof. Dr. R. K. Mishra, an internationally recognized laparoscopic surgeon and educator, demonstrates a Skin-to-Skin Laparoscopic Inguinal Hernia Repair using the Transabdominal Preperitoneal (TAPP) approach. This high-definition operative video provides an unedited, step-by-step demonstration of one of the most commonly performed minimally invasive hernia procedures, making it an invaluable educational resource for surgeons, residents, fellows, and medical students. The procedure begins with precise patient positioning, trocar placement, and safe laparoscopic entry into the abdominal cavity. Dr. Mishra carefully demonstrates the creation of the peritoneal flap, identification of critical anatomical landmarks, and meticulous dissection of the preperitoneal space. Special emphasis is placed on recognizing important structures such as the inferior epigastric vessels, Cooper's ligament, pubic symphysis, vas deferens, spermatic vessels, and the myopectineal orifice, ensuring a safe and anatomically sound repair. The video highlights complete reduction of the hernia sac while preserving surrounding neurovascular structures and avoiding injury to the cord structures. Viewers will gain practical insights into achieving the critical view of the myopectineal orifice, appropriate mesh selection, optimal mesh placement covering all potential hernia defects, and secure fixation techniques where indicated. The operation concludes with meticulous closure of the peritoneal flap, restoring normal anatomy and minimizing the risk of mesh exposure or bowel adhesion. This "Skin-to-Skin" demonstration showcases the efficiency of a standardized TAPP technique, illustrating how careful planning, advanced laparoscopic skills, and adherence to surgical principles can significantly reduce operative time without compromising patient safety or surgical quality. The procedure emphasizes gentle tissue handling, precise dissection, effective hemostasis, and ergonomic instrument movements that contribute to excellent postoperative outcomes. Laparoscopic TAPP repair offers several advantages over conventional open surgery, including smaller incisions, reduced postoperative pain, quicker recovery, earlier return to daily activities, improved cosmetic outcomes, and the ability to inspect and repair bilateral or occult hernias during the same operation. It has become one of the preferred techniques for inguinal hernia repair worldwide, particularly in experienced laparoscopic centers.