The Onstep Method for Inguinal Hernia Repair: Operative Technique and Technical Tips

Abstract

Inguinal hernia repair is one of the most common surgical procedures and several different surgical techniques are available. The Onstep method is a new promising technique. The technique is simple with a number of straightforward steps. This paper provides a full description of the technique together with tips and tricks to make it easy and without complications.

Figures

Figure 1

The incision is marked by the index and third fingers as shown.

Figure 2

The superficial epigastric vein in the subcutaneous tissue layer is cauterized.

Figure 3

The external aponeurosis is incised to expose the underlying internal aponeurosis.

Figure 4

Blunt dissection using the finger will create the necessary surgical space for the operation.

Figure 5

The cord is dissected and lifted out of the incision.

Figure 6

The index finger is used to plunge through the transversalis fascia into the preperitoneal space.

Figure 7

Moist sterile gauze is placed in the preperitoneal space.

Figure 8

The Onflex mesh is cut and the tails are placed around the spermatic cord.

Figure 9

The lateral parts of the Onflex mesh are removed.

Figure 10

The two tails in the Onflex mesh are closed with nonabsorbable interrupted sutures.

Figure 11

The gauze is removed.

Figure 12

The mesh is placed medially in the preperitoneal space.

Figure 13

The lateral part of the mesh is placed in the space between the internal and external aponeurosis, and the medial part of the mesh is positioned in the preperitoneal space.

Figure 14

The external fascia is closed with sutures and the skin is closed with sutures or staples.