**Author details**

**8. Our experience**

38 Hernia Surgery and Recent Developments

7–10 min on an average.

innovative technique.

**9. Conclusion**

**Acknowledgements**

son for always making me feel special.

was successfully repaired by our technique.

and always more acceptable to patients.

Since October 2014 we have operated 108 inguinal, 1 femoral & 1 obturator hernias. 109/110 cases were successfully completed by our technique. The average duration of first 5 mm port placement to access PPS was 2.5 min in comparison to Hasson trocar technique which takes

Pneumoperitoneum occurred in 23% cases that were managed by putting Veress needle. In all cases pneumoperitoneum occurred in later stages of surgery except one which was converted to TAPP because of adhesions due to past history of contralateral repair TEP repair of inguinal hernia. Thirteen cases of unilateral indirect inguinal hernias were irreducible and reduced during surgery by opening the sac. Ten cases of inguinal hernia patients underwent inguinal hernia repair of contralateral side. Three patients had recurrent inguinal hernia which were operated earlier by open mesh hernioplasty and subsequently repaired successfully by our

One patient had history of TEP repair for recurrent open inguinal hernia repair on the right side. This patient first presented in our outpatient department (OPD) with enterocutaneous fistula and mesh infection after TEP repair. Mesh removal along with disconnection of enterocutaneous fistula and laparoscopic repair of enterotomy after refreshing the margins was done. After complete healing of the wound by secondary intention, he was again subjected to

One patient developed right side inguinal hernia 2 years after bilateral orchidopexy, which

In our technique pain was less in comparison to Hasson trocar technique as all the ports are of 5 mm size. We reported no, SSI, chronic pain, hernia recurrence, incisional hernia or any other complications other than seroma on 6 months follow up. Smaller scars are cosmetically better

"555 Manish Technique" is simple, less invasive, less morbid, time saving, cost effective and having better cosmetic results with patient satisfaction. There is no dependence on Hasson Trocar & this technique does not compromise on the principles of current surgical procedure.

I am thankful to my teachers, my colleagues and my students who supported this work and guided me in need. I am grateful to my wife who is always there wherever I lack and to my

"Manish Retractor" plays a key role in successful completion of surgery.

TEP repair after 2 months and was successfully operated by our innovative technique.

Manish Kumar Gupta

Address all correspondence to: drmanishgupta2002@yahoo.com

Department of General and Laparoscopic Surgery, Sir Ganga Ram Hospital, New Delhi, India
