How is a patient positioned for laparoscopic inguinal hernia repair?

Updated: Apr 16, 2020
  • Author: Danny A Sherwinter, MD; Chief Editor: Kurt E Roberts, MD  more...
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Answer

The correct surgical site is confirmed and marked preoperatively in the holding area. The patient is placed in the supine position on the operating table. For large defects, slight Trendelenburg positioning may facilitate exposure by reducing the visceral contents into the abdomen.

The upper extremities are comfortably padded and tucked at the sides. (Some surgeons leave the arms out on armboards.) Even when a unilateral repair is scheduled, it is important to secure both arms, so that if an occult hernia is found on the contralateral side, it can be fixed during the same procedure.

The surgical site is shaved with electric clippers, then prepared and draped in standard surgical fashion so as to expose an extending area from above the umbilicus to below the pubis. The prepared area should be wide enough to permit conversion to an open technique if this should become necessary.

The operating surgeon stands on the side opposite the hernia, and the assistant stands on the side of the hernia. A single monitor or a pair of monitors may be placed at the foot of the bed. It is most convenient to have the light source, the carbon dioxide insufflator, and the video processor situated at the foot of the bed, though alternative locations will also work.


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