TEPP inguinal hernia

PROCEDURE
Paramedian longitudinal umbilical incision
Incise anterior sheath
Push rectus muscle aside
Push inflation dissector into space between rectus and posterior sheath and inflate under vision
Put Hasson into space after holding plane open with Langenbeck
Dissect hernial sac away
Inferior epigastric vessels
Purple trash
Triangles of doom and pain
Beware of iliac vessels inferiorly
Dissect lateral peritoneum
Cut mesh into shape
Put maxon/PDS suture on posterolateral surface of mesh and roll
Place into space
Tack medially and be careful placing tacks laterally