**8. Our experience**

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 7–10 min on an average.

**Author details**

**References**

Manish Kumar Gupta

fsurg.2014.00020

2009;**23**:482-486

Mar;**27**(3):295-303

Videoscopy. 2016;**26**(4)

1998;**5**:183-185

Medical Association. 2010;**108**:652-654

study of 163 cases. Hernia. 2003;**7**:125-129

learning curve. Minimally Invasive Surgery. 2014;**2014**:528517

Address all correspondence to: drmanishgupta2002@yahoo.com

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

"555 Manish Technique" for Mini TEP Repair http://dx.doi.org/10.5772/intechopen.76356 39

[1] Kockerling F, Schug-Pass C. Tailored approach in inguinal hernia repair—Decision tree based on the guidelines. Frontiers in Surgery. 2014;**1**:Article 20. DOI: 10.3389/

[2] Dulucq JL, Wintringer P, Mahajna A. Laparoscopic totally extraperitoneal inguinal hernia repair: Lesson learned from 3,100 hernia repairs over 15 years. Surgical Endoscopy.

[3] Rajapandian S, Senthilan P, Gupta A, Gupta PD, Praveenraj P, Vaitheeswaran V, Palanivelu C. Laparoscopic totally extraperitoneal repair of inguinal hernia using twohand approach—A gold standard alternative to open repair. Journal of the Indian

[4] Barrat C, Surlin V, etal BA. Management of recurrent inguinal hernias: A prospective

[5] Hasbahceci M, Basak F, Acar A, Alimoglu O. A new proposal for learning curve of TEP inguinal hernia repair: Ability to complete operation endoscopically as a first phase of

[6] Gupta MK, Muley KK, Bethanbhatla MK, Nanavati JD, Manish K, Sarangi R. Mini totally extra-peritoneal repair of inguinal hernia with all 5 mm ports: An innovative "555 Technique". Journal of Laparoendoscopic & Advanced Surgical Techniques. 2017

[7] Gupta MK, Bethanbhatla MK, Nanavati JD, Kumar M, Agarwal BB, Sarangi R. An innovative "555 Technique" for totally extra-peritoneal repair of inguinal hernia using all 5 mm ports. Journal of Laparoendoscopic & Advanced Surgical Techniques Part B,

[8] Lomanto D, Katara AN. Managing intra-operative complications during totally extraperitoneal repair of inguinal hernia. Journal of Minimal Access Surgery. 2006;**2**:165-170

[9] Hasson HM. Laparoscopic cannula cone with means for cannula stabilization and wound closure. The Journal of the American Association of Gynecologic Laparoscopists.

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 innovative technique.

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

One patient developed right side inguinal hernia 2 years after bilateral orchidopexy, which was successfully repaired by our technique.

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 and always more acceptable to patients.
