**7. Closure of all the infra-umbilical port site wounds**

**Figure 18.** Light weight polypropylene mesh is pulled inside through 5 mm port.

**Figure 17.** The end of long tail of silk thread is left inside the PPS.

36 Hernia Surgery and Recent Developments

port.

**Figure 19.** Rolled mesh is then pulled inside by holding and pulling the silk thread inside with grasper from another

All 5 mm trocars are taken out after deflating the space. The small 5 mm size of the infra-umbilical ports does not need any repair of ARS or subcutaneous fat. Skin is stapled as all the wounds are of 5 mm in size. The 12 mm infra-umbilical skin incision in Hasson trocar technique ultimately gets wider due to fixation of the large cone and ultimately becomes a size of 2.5–3.0 cm. Even the ARS fibers got teared because of the tight fixation of the tip of the cone and needs to be repaired along with subcutaneous fat with Vicryl. Larger incisions are always more prone for SSI and more pain [11]. All these complications are prevented in "555 Manish Technique" as it is done by all three 5 mm ports without deviating from the principles of TEP repair.
