In anycase of recurrent inguinal hernia is better to remouve the previous mesh or not ?
Is there an anatomic landmark for extension of the inferior peritoneum flap dissection in TAPP ?
Hi. If there is suspicion of chronic pain related to the mesh or meshoma yes. If not, ususally is NOT necessary
The inferior flap needs to accommodate well the mesh to avoid folding. Dissection of the vas deferent until it crossed the iliacs vessels and turns to the pelvis is a good medial landmark. Laterally we should dissect until once we pull the flap, the spermatic vessels don’t move/tent.
Ok thanks…. last question, what do you think about fenestrated mesh for TAPP. Is there some advantage with this type of mesh ??
NO!! not indicated to slit the mesh at MIS repairs