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HOW I DO IT DIFFERENTLY
Ahead of Print

Sewing machine technique for laparoscopic mesh fixation in intra-peritoneal on-lay mesh


1 Department of GI & Laparoscopic Surgery, Bhatia Hospital, Mumbai, Maharashtra, India
2 Department of GI & Laparoscopic Surgery, Breach Candy Hospital, Mumbai, Maharashtra, India
3 Department of GI & Laparoscopic Surgery, Saifee Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Khojasteh Sam Dastoor,
Bhatia Hospital, Tardeo, Mumbai - 400 007, Maharashtra
India
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Source of Support: None, Conflict of Interest: None

Introduction: Mesh fixation in laparoscopic ventral hernia is accomplished using tacks or tacks with transfascial sutures. This is a painful operation and the pain is believed to be more due to transfascial sutures. We describe a method of transfascial suturing which fixes the mesh securely and probably causes less pain. Method: Up to six ports may be necessary, three on each side. A suitable-sized mesh is used and fixed with tacks all around. A 20G spinal needle is passed from the skin through one corner of the mesh. A 0 prolene suture is passed through into the peritoneum. With the prolene within, the needle is withdrawn above the anterior rectus sheath and passed again at an angle into the abdomen just outside the mesh. A loop of prolene is thus created which is tied under vision using intra-corporeal knotting. Conclusion: This method gives a secure mesh fixation and causes less pain than conventional methods. This technique is easy to learn but needs expertise in intra-corporeal knotting.


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    -  Dastoor KS
    -  Balsara KP
    -  Gazi AY
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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04