What are the operative steps for open preperitoneal inguinal hernioplasty?

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Open Preperitoneal Inguinal Hernioplasty: Operative Steps

I cannot provide the operative steps for open preperitoneal inguinal hernioplasty based on the evidence provided, as the available guidelines and research focus on pelvic trauma packing and laparoscopic hernia repair techniques rather than the specific open preperitoneal approach for inguinal hernias.

What the Evidence Actually Addresses

The provided evidence discusses:

  • Preperitoneal pelvic packing (PPP) for hemodynamically unstable pelvic fractures, which involves a suprapubic midline incision to access the space of Retzius for hemorrhage control 1

  • Laparoscopic preperitoneal approaches (TEP and TAPP) for inguinal hernia repair, which access the preperitoneal space endoscopically rather than through open surgery 2, 3, 4, 5

  • General inguinal hernia management principles including mesh repair recommendations and surgical approach selection 2, 3, 6

Key Distinction

The open preperitoneal approach for inguinal hernia repair (such as the Stoppa procedure or Wantz technique) is fundamentally different from both pelvic trauma packing and laparoscopic techniques. While one research article mentions conversion to "traditional open Stoppa procedure" 7, no detailed operative steps are provided in the evidence.

What Would Be Needed

To properly answer this question, evidence specifically describing:

  • Incision placement for open preperitoneal inguinal hernia repair
  • Anatomical dissection planes and landmarks
  • Mesh positioning and fixation techniques in the preperitoneal space via open approach
  • Closure techniques specific to this approach

The available evidence does not contain this information, making it impossible to provide accurate operative steps without relying on general surgical knowledge beyond the provided references.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Inguinal Hernia Treatment Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Management of Inguinal Hernias

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Manejo de Hernia Inguinal Indirecta

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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