preperitoneal approach
Last reviewed 01/2018
Recurrent inguinal hernias can be repaired using a technique that involves placing a mesh posterior to the abdominal wall muscles but anterior to the peritoneum. Hence, there is no disturbance of the previous site of repair.
An incision is made into the rectus sheath superior to the original incision. Rectus abdominis is retracted medially to reveal the peritoneum. The deep surface of the inguinal region is exposed by retraction. A large mesh is placed over the region. It can be either sutured in place or left without formal fixation, instead relying on the positive pressure of the abdominal cavity to push it securely onto the back of the abdominal musculature.