TY  - JOUR
T1  - IMage of the month—quiz case
AU  - Misiakos EP, Liakakos T, Preza U, Fotiadis C, Macheras A
Y1  - 2009/06/01
N1  - 10.1001/archsurg.2009.69-a
JO  - Archives of Surgery
SP  - 589
EP  - 590
VL  - 144
IS  - 6
N2  - 
A 72-year-old patient presented with a bulging right scrotal hernia that caused worsening discomfort. The patient was a smoker and had hypertension that was being treated by medication. The hernia was repaired laparoscopically using the transabdominal preperitoneal polypropylene (TAPP) approach. At surgery the large sac of a direct hernia (with a small bowel loop within it) and the smaller sac of an indirect hernia were found. The hernia sac and its contents were reduced, and a piece of polypropylene mesh measuring 12 cm × 13 cm was placed preperitoneally and stabilized with tacks to the pubic symphysis and the pectineal ligament; thereafter, it was covered with a peritoneal patch.

SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2009.69-a
UR  - http://dx.doi.org/10.1001/archsurg.2009.69-a
ER  -