**9.2. Surgical supplies**

Standard laparoscopic equipment consisting of a camera, a monitor, a light and an insuflator


#### **9.3. Preparation of the patient, application of extraperitoneal trocars**

A single dose of 1 g second-generation cephalosporin as prophylactic antibiotic is injected half an hour before the onset of operation. The patient should urinate before operation and pre-operatory fluid resuscitation should be kept to a minimum. With general anesthesia, the operation starts in supine position. In method of TEP, the patient should be wider painted than the TAPP technique, from the nipple to the perineum. Infraumbilical, slightly lateralized incision is made on the hernia side and then the rectus sheath is opened by transverse incision. Rectus fibers are removed with Farabeuf retractor and blunt dissection is performed to reach the Bogros area. A tunnel is made between umbilicus to pubis. In front of this tunnel, there is a parietal peritoneum from the back of the rectus muscle and from the end of this fascia to the transverse course of the linea semilunaris. After blunt dissection and cannula is completely inserted from the preperitoneal tunnel to the pubis, it is removed from the trocar cannula and replaced with a telescope, and the cannula is inflated with a balloon attached to the mandrel. Air is discharged 20–25 times with puar after waiting for 30 s and this process is repeated three times. With some balloons, it is possible to view inside with scope as it inflates. It can also be monitored whether the definite surgical area is viewed during this observation. Upper view of rectus fibrils and lower view of parietal peritoneum indicates the right position. A 10 mm trocar is placed in the infraumbilical incision to prevent gas leakage and the telescope is placed. The preperitoneal space is inflated with 10–12 mmHg CO<sup>2</sup> . Two 5 mm ports are placed at a distance of 5 cm from the midline in direct view (**Figure 7**).
