Inguinal Test Answers

Question 1

TEP repairs require the use of _____, which separate the fascial layers to make room for the mesh in the _____ space. In a TAPP repair the surgeon uses ports to go into the _______ cavity first.

Answer 1

1. Dissector
2. preperitoneal
3. intra-abdominal

Question 2

The _____ canal is the path between the internal & external rings. Its ceiling is the ______ oblique and its floor is the _______ ______.

Answer 2

1. inguinal
2. external
3. transversalis fascia

Question 3

The inguinal ______ connects the ASIS & Pubic Tubercle.

Answer 3

ligament

Question 4

One natural weakness in the groin is because the internal oblique AND _____ _______ muscles do not extend all the way down to the inguinal ligament, leaving the transversalis fascia exposed. This is where ______ hernias occur.

Answer 4

transverse abdominus

direct

Question 5

Situation: Your surgeon is placing 3D Max using a TAPP technique and doesn’t want to fixate. Is that an issue?

Answer 5

No - the peritoneum will be reapproximated to cover the mesh and 3D max is self-fixating.

Question 6

Which of the following are advantages of the Lichetenstein repair over tissue to tissue:

a. less tension
b. higher costs
c. lower recurrence rates
d. higher pain
e. can be done in children

Answer 6

a. less tension

c. lower recurrence rates

Question 7

Direct hernias the sac is _____. These occur _____ to the epigastric vessels. These most often occur in _____.

Answer 7

transversalis fascia
medial
men

Question 8

Indirect hernias the sac is _____. These hernias occur _____ to the epigastric vessels. These most often occur in ____.

Answer 8

peritoneum
lateral
men

Question 9

The crest in 3D max mesh corresponds with what structure?

Answer 9

inguinal ligament

Question 10

The notch in 3D max corresponds with what structure?

Answer 10

illiac vessels

Question 11

The Bard inguinal product that is most commonly used with robotics is ____.

Answer 11

3D Max

Question 12

What structures make up Hasselbach’s triangle?

Answer 12

1. rectus abdominus
2. epigastric vessels
3. inguinal ligament

Question 13

In inguinal procedures what tissue plane is the surgeon placing the mesh?

Answer 13

preperitoneal

Question 14

T/F - The “inguinal floor” is the transversalis fascia.

Answer 14

True

Question 15

What is the importance of fixating the peritoneum in a TAPP procedure.

Answer 15

Protect the bowel from growing into the mesh.

Question 16

Know inguinal anatomy picture w/ triangle of doom and pain.

Answer 16

Right facing picture.

Question 17

Describe the 2 differences between TAPP and TEP repairs.

Answer 17

TAPP you create a “trap door” and enter through the belly. You shave off the peritoneum and place the mesh preperioteneal. Reapproximate peritoneum and exit.

TEP you do not compromise peritoneum. enter through the skin, then use balloon to remove peritoneum from rest of layers.

Question 18

What does the blue marker on 3D Max stand for?

Answer 18

Medial

Question 19

What is the name of the Plug technique that is most common?

Answer 19

Milikan

Question 20

What are 2 disadvantages of Lichtenstein repair?

Answer 20

lots of sutures

can only be used open

Question 21

Progrip is sold by ____ and it’s made of _____ mesh. ProGrip’s main design feature is its ______ that allow them to market it as ____-_____.

Answer 21

Medtronic
polyester
self-fixating

Question 22

The Bard products that compete against it are:

Answer 22

3D Max and 3D Max Light

Question 23

List two selling points against ProGrip:

Answer 23

• expensive

- polyester causes more inflammatory response

Question 24

Give a description of the product and list a weakness/selling point of it:

• Ultrapro
• Prolene Hernia System

Answer 24

-UltraPro:
Ethicon popypropylene synthetic and bioresorbable made with minocryl. No ring or patch.

• Prolene Hernia System
  Ethicon monofilament polypropylene. (Flat Sheet). No patch, no ring, no plug.

Question 25

Prolene Hernia System is manufacture by:

Answer 25

Ethicon

Question 26

ProLoop Plug is manufacture by:

Answer 26

Atrium

Question 27

Paritex is manufacture by:

Answer 27

Covidian/Medtronic

Question 28

Ultra Pro is manufacture by:

Answer 28

Ethicon