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9. Inguinal hernia repair procedure on a 43 year old male. Dr. Gudu completed 5 hernia procedures on the same day, and 72 hernia repairs in 2015. There are no mesh screens available for abdominal or inguinal hernia repairs to strengthen the abdominal wall. What is the name of the technique that Dr. Gudu uses for inguinal hernia repair? #gmhrounds

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Chief Complaint:
Left inguinal pain and discomfort.
History:
Patient presented with progressive discomfort in the left inguinal region, exacerbated by physical activity. No gastrointestinal symptoms or prior complications were reported.
Diagnostic Workup:
Clinical evaluation was consistent with a left inguinal hernia.
Diagnosis:
Left inguinal hernia.
Treatment:
Laparoscopic TAPP repair was performed with placement of a large heavy-weight 3D Max mesh.
Outcome:
The procedure was completed without complications, with adequate reinforcement of the inguinal region.

This is a photo of a very impressive umbilical hernia repaired as an open procedure under general anesthesia. In my current facility, open hernia repairs are usually performed under MAC sedation. Since this client was previously taking Ozempic despite maintaining proper NPO status, he was a candidate for intubation due to delayed gastric emptying properties of the medication. No mesh was used for this case. The herniation was repaired using sutures, mainly consisting of 2-0 Maxon.\

Male, 30 years old
Medical History:

1. Right inguinal hernia\
   • Right inguinal TAPP\
   • Recurrence of right inguinal hernia\
   • Mesh infection\
   • Laparoscopic abscess drainage\
   • Persistent infection\
   • Anterior drainage and use of negative pressure wound therapy\
2. Umbilical hernia\
   • Mesh repair\
   • Mesh infection\
   • Anterior drainage
     Current Diagnosis:
     Recurrent right inguinal hernia
     Midline incisional hernia and diastasis recti
     Preoperative Protocol:
     Abdominal CT scan: Incisional hernia and right inguinal hernia
     Treatment:
     TAP block
     Rives Stoppa with retromuscular mesh
     Right Lichtenstein

59yr old male with hx of right inguinal hernia. This is left indirect inguinal hernia repair with the mesh. I hope you can appreciate the hernia sac.