Improvement in endoscopic hernioplasty: transcutaneous aquadissection of the musculofascial defect and preperitoneal endoscopic patch repair.

Since abdominal wall herniae derive from the abdominal cavity, they are accessible to laparoscopic diagnosis and treatment. This may be more appropriate than the conventional external approach. In five gynecological patients, scheduled for pelviscopic surgery, a coexisting inguinal hernia was endoscopically repaired. Transcutaneous aquadissection of the musculofascial defect using physiological saline solution in a syringe was easy to perform and very helpful in the endoscopic dissection of the peritoneal space. The method is described in specific detail, and recommended for application.