{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:19:10Z","timestamp":1787023150523,"version":"build-2736575974"},"reference-count":14,"publisher":"FapUNIFESP (SciELO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ABCD, arq. bras. cir. dig."],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:p>BACKGROUND: Among endoscopic hernioplasties, totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) approach are widely accepted alternatives to open surgery, both providing less postoperative pain, hospital length of stay and early return to work. Classical TEP technique requires three skin incisions for placement of three trocars in the midline or in triangulation. AIM: To describe a technique using only two trocars for laparoscopic total extraperitoneal for inguinal hernia repair. METHOD: Extraperitoneal access: place two regular trocars on the midline. The 10 mm is inserted into the subcutaneous in horizontal direction after a transverse infra-umbilical incision and then elevated at 60\u00ba angle. The 5 mm trocar is inserted at the same level of the pubis with direct vision. Preperitoneal space dissection: introduction 0\u00ba optical laparoscope through the infra-umbilical incision for visualization and preperitoneal dissection; insufflation pressure must be below 12 mmHg. Dissection of some anatomical landmarks: pubic bone, arcuate line and inferior epigastric vessels. Exposure of \"triangle of pain\" and \"triangle of doom\". Insertion through the 10 mm trocar polypropylene mesh of 10x15 cm to cover the hernia sites. Peritoneal sac and the dorsal edge of the mesh are repositioned in order to avoid bending or mesh displacement. It is also important to remember that the drainage is not necessary. RESULTS: The 2-port TEP required less financial costs than usual because it is not necessary an auxiliary surgeon to perform the technique. Trocars, suturing material and wound dressing were spared in comparison to the classical technique. Besides, there were only two incisions, which provides a better plastic result and less postoperative pain. CONCLUSION: The TEP technique using two trocars is an alternative technique which improves cosmetic and financial outcomes.<\/jats:p>","DOI":"10.1590\/s0102-67202015000200009","type":"journal-article","created":{"date-parts":[[2015,7,8]],"date-time":"2015-07-08T19:24:21Z","timestamp":1436383461000},"page":"121-123","source":"Crossref","is-referenced-by-count":9,"title":["Laparoscopic totally extraperitoneal (TEP) hernioplasty using two trocars: anatomical landmarks and surgical technique"],"prefix":"10.1590","volume":"28","author":[{"given":"Leandro Ryuchi","family":"IUAMOTO","sequence":"first","affiliation":[{"name":"University of S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Mika","family":"KATO","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"MEYER","sequence":"additional","affiliation":[{"name":"Samaritano Hospital, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"BLANC","sequence":"additional","affiliation":[{"name":"Clinique Chirurgicale Mutualiste, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"3355","DOI":"10.1007\/s00464-012-2382-5","article-title":"Which is the best laparoscopic approach for inguinal hernia repair: TEP or TAPP? 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The case for bilateral repair","volume":"24","author":"Pawanindra Lal","year":"2010","journal-title":"Surg Endosc"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/S0039-6109(16)46027-5","article-title":"Demographic, classificatory and socioeconomic aspects of hernia repair in the United States","volume":"73","author":"Rutkow I M","year":"1993","journal-title":"Surg Clin North Am"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s10029-009-0529-7","article-title":"European Hernia Society guidelines on the treatment of inguinal hernia in adult patients","volume":"13","author":"Simons MP","year":"2009","journal-title":"Hernia"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1258\/RSMSMJ.53.1.34","article-title":"Laparoscopic hernia repair","volume":"53","author":"Tse GH","year":"2008","journal-title":"Scott Med J"}],"container-title":["ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S\u00e3o Paulo)"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/abcd\/v28n2\/0102-6720-abcd-28-02-00121.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,4]],"date-time":"2020-09-04T16:30:27Z","timestamp":1599237027000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-67202015000200121&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015,6]]}},"alternative-id":["S0102-67202015000200121"],"URL":"https:\/\/doi.org\/10.1590\/s0102-67202015000200009","relation":{},"ISSN":["0102-6720"],"issn-type":[{"value":"0102-6720","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6]]}}}