Inguinal Flashcards
The Bassini Technique
“Shade to window sill”
Pulling muscle down to eliminate gap- to the inguinal ligament
Tissue to tissue
The McVay Technique
Tissue to tissue
Pulling muscle down to coopers ligament
“Shade past window sill”
The shouldice technique
“Canadian Technique”
Suturing each individual layer
TAPP stands for
Transabdominal PrePeritoneal Approach
TEP stands for
Totally extra Peritoneal approach
Where is the Millikan and Classic technique placed?
PrePeritoneal
Only recommended classic technique
Femoral Hernia
Keys to Onflex/ MK Technique
Dissection KEY!!!
Cover hasselbachs triangle and coopers ligament
TAPP pros and cons and description
- more space
- through belly- back out through peritoneum placing mesh in pre peritoneal
- peritoneum is incised “ trap door”
- violates healthy peritoneum
TEP
- close and confined area
- staying out of the belly- through umbilical
- dissect down to PrePeritoneaum
- uses a ballon but not always to open and separate muscle from peritoneum
- mesh placed pre peritoneal
- doesn’t violate healthy peritoneum
“Me too” products
Atrium
Lichtenstein repairs is the lap approach with mesh and require a lot of sutures?
False- open
Mesh repair technique for open repairs
Lichtenstein anterior to anterior
Plug repair - anterior to anterior or posterior
MK technique - anterior to posterior
Lap mesh repair technique
Tapp
Tep
Perfix plug S-L equals
Inner petals
Perfix plug XL….
3 inner cones instead of petals
No key hole for PerFix light Plug true or false
True
Bio A gore was discontinued and now BD has what?
PHASIX Plug
4 sizes
Which Bd product can cover I direct, direct and femoral hernias
OnFlex
In both approaches TEP and TAPP mesh is placed where…
Preperitoneal space
3DMax doesn’t t require fixation? True or false
True
3D Max anatomical shape to fit inguinal canal
Crest- inguinal ligament
Notch - Illiac Vessels
ETHICON UltraPro plug (UPP) Facts
50% absorbable (119 days)
IFU= DONT use more than 2 larges in 4 months
3D Max vs Progrip
3DMax on avg takes 29 minutes less than ProGrip
3DMax $1,975 less than ProGrip
More pain in the first 48 hrs- ProGrip
ProGrip Open - Expensive
2D Wave- rigid mesh
Polyester = Weaker made it Multifilament
- multifilament historically harbors bacteria
New product - Duatene- Polypropylene mesh + synthetic
Now they start pushing polypropylene for decades of pushing polyester
Name the 2 main Medtronic products?
Progrip & Parieitex
Direct hernias sac
Transversals Fascia
