1. TAPP REPAIR FOR INGUINAL HERNIA -
DR. SANKPAL'S REPAIR
Presenting Author : DR. JITENDRA T. SANKPAL MS (MUM) FICS FIAGES Prof. & H.O.D. Co-authors : Dr. S.V. Daga, Dr. Shriniketan Kale, Dr. S.N.Bamne, Dr. Shweta Shende Dept. of General & G.I. Lap. Surgery Dr. V.M. Govt. Medical College, Solapur.

2. Dr. V.M.Govt.Medical College, Solapur.

3. Demography JAN—DEC 2006
Total no. of cases Total no. of hernioplasties - 54
Unilateral cases 46 (indirect 40 , direct 6 )
Bilateral cases 4 (indirect 4 , direct 4 )
Anaesthesia GA 24 Cases
SA 26 cases

4. PORT SITES . 10 mm umbilical - Telescope 00 
PORT SITES  10 mm umbilical - Telescope 00  10 mm lateral and at level of umbilicus on side of hernia  5 mm lateral and below umbilicus on side opposite to hernia.  No RT insertion or Urinary catheter  Peri-operative 1 gm injection cefotaxime IV.

5. PORT POSITION
Surgeon
Assistant
5mm
Camera
10 mm
Monitor

8. OBSERVATION Mean operative time (min.)
Mean hospital stay hours

9. Analgesic requirement Pain score not measured but 90 % of patients didn’t required analgesic beyond 48 hours. Return to activity of daily living : Home activities to 5 days Work activities to 7 days

10. OBSERVATION Complication - Port site infection in. -
OBSERVATION Complication - Port site infection in - Three patient Urinary retention Nil Bleeding Nil Chronic pain / Neuralgia - Nil Heamatoma Nil Scrotal seroma Three patient Testicular pain / swelling - Nil Hydrocoele Nil Enterotomy Nil Bladder injury Nil Intestinal obstruction Nil

11. Conversion to open - Nil
- Mean follow up was 12 months
- No recurrence

12. RECURRENCE RATE : Schultz et al (1994)
Recurrence mainly associated with placement of sufficient sized prosthesis (10cm x 15cm )

13. CONCLUSION . Simple, cost effective, time saving. 
CONCLUSION  Simple, cost effective, time saving.  Steps prone for complications are avoided  More reliable repair for beginners  Irreducible obstructed hernia can be manage.  CO2 absorption is less than in TEP repair.  Procedure of choice for patients with lower abdominal incision.  Unexpected contra lateral hernia can be managed.  Diagnostic peritoneoscopy is possible  Simultaneous appendicectomy, adhesiolysis cholecystectomy etc. feasible.

14. IT’S MY SAFE, SIMPLE, COST EFFECTIVE & INNOVATIVE REPAIR TO PASS ON BENEFITS OF LAPAROSCOPIC SURGERY TO HERNIA PATIENTS, INSPITE OF NON AVAILABILITY OF SOPHASTICATED INSTRUMENTS AND COSTLY TUCKERS.

15. Thank You