A direct hernia is usually evident as the balloon peels the peritoneum
down. An indirect hernia sac lies atop the internal spermatic vessels
and is not inflated because of the extraperitoneal location. It may be difficult
to find and care should be taken in the dissection not to damage the spermatic
vessels. The groin is left accessible when draping so that a finer can be
placed in the inguinal canal if necessary to aid in diagnosis and dissection.
Non-absorbable mesh is introduced through the camera port and
positioned over the inguinal floor on one or both sides as indicated. The
mesh is fixed in position at Cooper's, rectus and transversus. No staples
are placed below iliopubic tract laterally to avoid injuring lateral femoral
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