title: Early results of dual approach hernioplasty (DAH): an innovative laparoscopic inguinal hernioplasty technique.
abstract: BACKGROUND
  In this study, the proposed technique is combining the invented method of extraperitoneal dissection utilizing gas insufflation through Veress needle introduced from the groin with the transabdominal approach. Such a combination minimizes operative demands, achieves major goals, and reduce operative time in an attempt to improve laparoscopic hernioplasty techniques.
  
  
  METHODS
  The study recruited 211 patients having primary reducible inguinal hernia upon first diagnosis. Abdominal ultrasound examination achieved to exclude any additional pathology and confirming clinical diagnosis. The new technique is applied on all patients without any modification through the whole series.
  
  
  RESULTS
  Patients' epidemiology, operative characteristics, and follow-up are all tabulated. Results showed no complications nor conversion to open procedure.
  
  
  CONCLUSIONS
  The proposed procedure showed preliminary encouraging results regarding technique, clinical outcome, time-saving, and patients' safety. Combination of extraperitoneal gas-derived dissection, transabdominal field review, and preperitoneal mesh application offers an innovative and promising laparoscopic hernioplasty technique. The study is introducing the technique and as well invites further trials on wider scale to verify the technique.
authors.affiliation: University Medical Center, Arabian Gulf University, Manama, Kingdom of Bahrain. drmdnasr@gmail.com.
authors.forename: Mohamed Mahmood
authors.initials: MM
authors.lastname: Nasr
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007327:Insufflation; D010535:Laparoscopy / Q000379:methods; D008297:Male; D061646:Operative Time; D061214:Patient Safety; D010865:Pilot Projects; D011183:Postoperative Complications / Q000601:surgery*; D013526:Surgical Mesh; D016896:Treatment Outcome
keywords: Gas tissue dissection; Preperitoneal gas dissection transabdominal hernioplasty; Totally extraperitoneal hernioplasty; Transabdominal preperitoneal hernioplasty