After a subumbilical transverse skin incision, the anterior rectus sheath is exposed with two Langenbeck retractors and incised transversely with a scalpel. The medial edge of the rectus muscle is loaded onto the retractors and a dissection balloon is introduced. This balloon glides on the posterior layer of the rectus sheath up to the pubic bone. Under visual control with the 0° optics, the expansion of the extraperitoneal space allows for blunt dissection and clear identification of the key structures: pubic bone, rectus muscle, and epigastric vessels. The balloon is removed and the incised anterior rectus sheath is reinforced with braided, absorbable sutures of size 0.
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Access to the Extraperitoneal Space
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Insertion of the Optic and First Working Trocar
Now a blunt gas-tight 10 mm trocar with a fixation device is inserted and secured with the pre-plac
Now a blunt gas-tight 10 mm trocar with a fixation device is inserted and secured with the pre-plac
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