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How to Treat Recurrence After TEP

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George S. Ferzli
George S. Ferzli
Salud y medicinaEmpresariales
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How to Treat Recurrence after TEP George S. Ferzli, M.D., F.A.C.S. Professor of Surgery SUNY Health Sciences Center Brooklyn New York George Al-Khoury,M.D.
THREE OPTIONS ,[object Object],[object Object],[object Object]
Repair of recurrences after endoscopic repair TEP 1 Open 7 0 8 Richards 2004 TEP 12 12 Ferzli 2004 TEP 2 TAPP 3 Open 18 23 23 Tamme 2003 TAPP 4 6 6 Chowbey 2003 TAPP 0 46 Leibl 2000 TAPP 9 34 Knook 1999 TAPP 29 Open 4 11 34 Felix 1998 Repair Primary TEP Cases Study
Repair of recurrences after endoscopic repair TEP 1 Open 7 0 8 Richards 2004 TEP 12 12 Ferzli 2004 TEP 2 TAPP 3 Open 18 23 23 Tamme 2003 TAPP 4 6 6 Chowbey 2003 TAPP 0 46 Leibl 2000 TAPP 9 34 Knook 1999 TAPP 29 Open 4 11 34 Felix 1998 Repair Primary TEP Cases Study
Repair of recurrences after endoscopic repair TEP 1 Open 7 0 8 Richards 2004 TEP 12 12 Ferzli 2004 TEP 2 TAPP 3 Open 18 23 23 Tamme 2003 TAPP 4 6 6 Chowbey 2003 TAPP 0 46 Leibl 2000 TAPP 9 34 Knook 1999 TAPP 29 Open 4 11 34 Felix 1998 Repair Primary TEP Cases Study
EERPE after TEP/TAPP ,[object Object],[object Object],[object Object],[object Object],[object Object],Stolzenburg J. et al: EERPE in patients with prostate cancer and previous laparoscopic inguinal mesh placement for hernia repair. World J Urol 23:295-299, 2005.
EERPE after TEP/TAPP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Stolzenburg J. et al: EERPE in patients with prostate cancer and previous laparoscopic inguinal mesh placement for hernia repair. World J Urol 23:295-299, 2005.
EERPE after TEP/TAPP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Stolzenburg J. et al: EERPE in patients with prostate cancer and previous laparoscopic inguinal mesh placement for hernia repair. World J Urol 23:295-299, 2005.
TEP after TEP 14-year experience ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TEP after TEP 14-year experience ,[object Object],[object Object],[object Object],[object Object]
TEP after TEP 14-year experience ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RESULTS ,[object Object],[object Object],[object Object],[object Object],[object Object]
Conversions to open ,[object Object],[object Object],[object Object],[object Object],[object Object]
PATIENT POSITION
BLUNT FINGER DISSECTION
LIMITED SPACE
7 STEPS
CARDINAL RULES
TOTAL ANATOMY
MESH PLACEMENT
EPIGASTRIC VESSELs ,[object Object]
INDIRECT
INDIRECT 2
DIRECT
Lipoma
Video tapes
Conclusion ,[object Object],[object Object],[object Object],[object Object]
Conclusion 2
TEP technique – indirect hernia ,[object Object],[object Object],[object Object],[object Object],[object Object]
TEP technique – indirect hernia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TEP technique – direct hernia ,[object Object],[object Object],[object Object],[object Object]
To reduce hernia recurrence ,[object Object],[object Object],[object Object],[object Object],[object Object]
TEP after TEP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TEP after TEP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Repair of recurrences after endoscopic repair ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TEP after TEP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TEP after TEP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Tamme C. et al: TEP: Results of 5203 hernia repairs. Surg Endosc 17:190-195, 2003.
TEP after lower abdominal surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TEP after lower abdominal surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Paterson H. et al: Totally extraperitoneal laparoscopic repair in patients with previous lower abdominal surgery. Hernia June 24, 2005.
TEP after TEP 14-year experience ,[object Object],[object Object],[object Object]
TEP technique ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TEP technique ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TEP technique ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]

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How to Treat Recurrence After TEP

  • 1. How to Treat Recurrence after TEP George S. Ferzli, M.D., F.A.C.S. Professor of Surgery SUNY Health Sciences Center Brooklyn New York George Al-Khoury,M.D.
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  • 3. Repair of recurrences after endoscopic repair TEP 1 Open 7 0 8 Richards 2004 TEP 12 12 Ferzli 2004 TEP 2 TAPP 3 Open 18 23 23 Tamme 2003 TAPP 4 6 6 Chowbey 2003 TAPP 0 46 Leibl 2000 TAPP 9 34 Knook 1999 TAPP 29 Open 4 11 34 Felix 1998 Repair Primary TEP Cases Study
  • 4. Repair of recurrences after endoscopic repair TEP 1 Open 7 0 8 Richards 2004 TEP 12 12 Ferzli 2004 TEP 2 TAPP 3 Open 18 23 23 Tamme 2003 TAPP 4 6 6 Chowbey 2003 TAPP 0 46 Leibl 2000 TAPP 9 34 Knook 1999 TAPP 29 Open 4 11 34 Felix 1998 Repair Primary TEP Cases Study
  • 5. Repair of recurrences after endoscopic repair TEP 1 Open 7 0 8 Richards 2004 TEP 12 12 Ferzli 2004 TEP 2 TAPP 3 Open 18 23 23 Tamme 2003 TAPP 4 6 6 Chowbey 2003 TAPP 0 46 Leibl 2000 TAPP 9 34 Knook 1999 TAPP 29 Open 4 11 34 Felix 1998 Repair Primary TEP Cases Study
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Notas del editor

  1. Reference #12-can’t get it online; 6-got it
  2. Ref 27, 28-got ‘em
  3. Ref 18-didn’t get it—try online at home with membership; 19, 20-got ‘em
  4. Ref 29-can’t get it online