{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:16:01Z","timestamp":1778199361517,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T00:00:00Z","timestamp":1602547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Peritoneal injury during laparoscopic totally extraperitoneal (TEP) inguinal hernia repair is an intraoperative complication that affects accomplishment. We retrospectively examined the causes of peritoneal injury and methods of TEP repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study examined 58 patients with inguinal hernia (43 unilateral, 15 bilateral) who had undergone TEP repair; all procedures were performed by the same surgeon. The incidence of peritoneal injury, clinical characteristics that could have influenced peritoneal injury, and management of the injury were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Peritoneal injury was noted in 16 inguinal hernias (21.9%, 16 \/73). Injury occurred more frequently in right\u2010sided hernias than in left\u2010sided hernias (31.6% vs 11.4%, <jats:italic>P<\/jats:italic>\u00a0=\u2009.049). No other factors were related to injury. Peritoneal injury occurred due to anatomical misrecognition in five hernias (31.3%, 5\/16) and unintentional dissection in six hernias (37.5%, 6\/16). All injuries due to unintentional dissection occurred in right\u2010sided hernias. The procedures used for peritoneal injury repair were endoscopic suturing for 4 hernias, pre\u2010tied loop ligation for 1 hernia, and ligation clips in 11 hernias. Additional techniques were required in three hernias repaired by endoscopic suturing (75% 3\/4). After introduction of the ligation clips, endoscopic suturing was discontinued, and no additional techniques were needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Peritoneal injury more frequently occurred in right\u2010sided inguinal hernia than in left\u2010sided inguinal hernia during TEP repair. The common reasons for peritoneal injury were anatomical misrecognition and unintentional dissection. Repair using ligation clips is the best option for peritoneal injuries that occur during TEP repair.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ases.12869","type":"journal-article","created":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T04:22:28Z","timestamp":1602649348000},"page":"353-360","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Causes of peritoneal injury during laparoscopic totally extraperitoneal inguinal hernia repair and methods of repair"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8862-0372","authenticated-orcid":false,"given":"Tsuyoshi","family":"Koyama","sequence":"first","affiliation":[{"name":"Department of Surgery Meijibashi Hospital  Matsubara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhang","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Surgery Moriguchi Ikuno Memorial Hospital  Moriguchi 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