The gauze technique for a rapid dissection of the pre-peritoneal space in laparoscopic inguinal hernia repair - a video vignette.

The aim of Video S1 is to describe a new pre‐peritoneal atraumatic dissection of a peritoneal flap during laparoscopic transabdominal pre‐peritoneal inguinal hernia repair. In all operations, after opening the peritoneum a laparoscopic sterile gauze (5 × 5 cm) was introduced through the 10 mm trocar and through the peritoneal incision. This was then used for the dissection of the surrounding structures from the abdominal wall without the use of an energy source and sharp instruments. With blunt dissection and with the help of the pneumoperitoneum, the pre‐peritoneal space is dissected until the Cooper’s ligament is visible. All procedures performed with this technique were without complication. The median time of bilateral hernia repair was 63 min (15 cases). This procedure is quicker than that reported in the literature. Laparoscopic transabdominal pre‐peritoneal inguinal hernia repair using a gauze technique is a feasible way to create a pre‐peritoneal flap with atraumatic technique. This technique is quick and may be able to reduce the learning curve for this procedure