APPROACH TO HERNIA Dr. R. K. Mishra World Laparoscopy Hospital Essentials of Laparoscopic Surgery PRICE BEING PAID BY MANKIND FOR THE ERRECT POSTURE World Laparoscopy Hospital Essentials of Laparoscopic Surgery HISTORY  Operations began as early as 800 BC in India.  19th century - Edoardo Bassini - Italian  1983 – Tension Free Repair  1987 – Laparoscopic Repair World Laparoscopy Hospital Essentials of Laparoscopic Surgery CLASSIFICATION SITE: Inguinal, Femoral, Umbilical, Epigastric, Hiatal, Lumbar etc. OCCURRENCE: Primary, Recurrent, Incisional CLINICAL: Reducible, Irreducible, Obstructed, Strangulated World Laparoscopy Hospital Essentials of Laparoscopic Surgery TREATMENT OF HERNIA AS OLD AS HISTORY OF MEDICINE World Laparoscopy Hospital Essentials of Laparoscopic Surgery TREATMENT  Conservative seldom indicated  Surgery Open  Laparoscopic  Totally Extra  Peritoneal (TEP) Trans Abdominal  Pre Peritoneal (TAPP) World Laparoscopy Hospital Essentials of Laparoscopic Surgery TAPP Versus TEP Currently, Total extraperitoneal repair of hernia is considered the method of choice. Transabdominal preperitoneal repair is technically easier then Total extraperitoneal repair. World Laparoscopy Hospital Essentials of Laparoscopic Surgery World Laparoscopy Hospital Essentials of Laparoscopic Surgery HERNIA World Laparoscopy Hospital Essentials of Laparoscopic Surgery World Laparoscopy Hospital Essentials of Laparoscopic Surgery