After infraumbilical transverse skin incision, expose the anterior rectus sheath with two Langenbeck retractors and incise it transversely with the scalpel. Retract the medial edge of the rectus muscle with the retractor and insert the dissecting balloon. Slides it on the posterior lamina of the rectus sheath to the pubic bone. Under direct vision with the 0° laparoscope, balloon dilation will bluntly dissect and thus help to clearly identify the guiding structures of the pubic bone, rectus muscle, and epigastric vessels. Remove the balloon and arm the incised anterior rectus sheath with braided size 0 absorbable sutures.
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Access to the preperitoneal space
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Inserting the laparoscope and first working trocar
Soundsettings Now, insert a Hasson trocar is inserted and securely fixed with the preplaced sutures. In most cases, a working pressure of 7 mmHg suffices to adequately unfold the preperitoneal space. Insert a 5 mm trocar at least 5 cm above the pubic bone in the midline.
Tip:
An insulated 5 mm trocar with short thread is recommended.
Dissecting the preperitoneal space and inserting the third trocar
While expand the medial preperitoneal space with the Overholt and laparoscope, the midline will be
While expand the medial preperitoneal space with the Overholt and laparoscope, the midline will be
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