{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:04:46Z","timestamp":1791529486398,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100016077","name":"Dongguan Science and Technology Bureau","doi-asserted-by":"crossref","award":["202050715009218"],"award-info":[{"award-number":["202050715009218"]}],"id":[{"id":"10.13039\/501100016077","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Minimally Invasive Surgery"],"published-print":{"date-parts":[[2021,4,21]]},"abstract":"<jats:p>Background. Totally extraperitoneal herniorrhaphy (TEP) is a therapeutic challenge because of its complex anatomical location in inguinal region. The aim of this study was to describe the related surgical anatomy through laparoscopic observation and share the lessons learned from a review of 250 primary inguinal hernia repair procedures performed at our hospital from January 2013 to November 2019. Patients and Methods. There were 245 men and 5 women (median age: 63.2 years). Right hernia (60.2%) was the most common site. Indirect hernia (60.5%) was the most common abnormality. The classification of type II (65.0%) was the most common form. Surgical techniques comprised retromuscular approach using cauterized dissection, management of variations of arcuate line, Retzius space and Bogros space dissection, hernia sac reduction, and mesh positioning. Results. The incidence of peritoneum injury was in 27 (10.1%). No epigastric vessels were injured. There were 8 (3%) hematoma and 18 (6.8%) seroma. No mesh infection, chronic pain, and recurrence were found after follow-up of an average of 35 months. Conclusion. A good understanding of the anatomically complex nature in the inguinal region can make it easier and safer to learn the TEP approach. Early and midterm outcomes after TEP are satisfactory.<\/jats:p>","DOI":"10.1155\/2021\/5524986","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T22:54:47Z","timestamp":1619132087000},"page":"1-8","source":"Crossref","is-referenced-by-count":5,"title":["Totally Extraperitoneal Herniorrhaphy (TEP): Lessons Learned from Anatomical Observations"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1023-0611","authenticated-orcid":true,"given":"Xue-Lu","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Surgery, Chashan Hospital of Guangdong Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Hua","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Chashan Hospital of Guangdong Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Chashan Hospital of Guangdong Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You-Hua","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Chashan Hospital of Guangdong Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan-Bin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Chashan Hospital of Guangdong Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-010-0739-z"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-017-1668-x"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1111\/ases.12639"},{"key":"4","first-page":"1","article-title":"Artificial arcuate line: surgical creation during TEPP hernioplasty","volume":"2","author":"M. 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Wang","year":"2011","journal-title":"Chinese Journal of Surgical Oncology"},{"issue":"7","key":"13","first-page":"656","article-title":"Analysis of reasons and management of intraoperative bleeding in total extraperitoneal laparoscopic inguinal hernia repair","volume":"13","author":"L. Wu","year":"2013","journal-title":"Chinese Journal of Surgical Oncology"},{"issue":"1","key":"14","first-page":"34","article-title":"Bleeding control and anatomical analysis in laparoscopic inguinal hernia repair","volume":"10","author":"H. Zong","year":"2016","journal-title":"Prospects of Hernia and Abdorminal Wall Surgery in China"},{"issue":"3","key":"15","first-page":"233","article-title":"Subabdominal hematoma and peritoneal hematocele following totally extraperitoneal herniorrhaphy: report of one case","volume":"10","author":"J. 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