The inferior epigastric vessels were clearly visualized laterally on the posterior surface of the rectus muscle. The retropubic space of Retzius Oligomycin A purchase and the space of Bogros were easily expanded by this telescopic approach. Two 5mm trocars were introduced between the umbilicus and the symphysis pubis. The hernia defect was identified. Dissection of the peritoneal sac from the cord structures in cases of laterally placed indirect inguinal hernia or retraction from the abdominal wall defect in cases of medially placed direct inguinal hernia or both in cases of combined inguinal hernia were performed. Dissection of indirect inguinal hernia sac was completed either by reduction or transection in which it was closed by metallic clips. Peritoneal defects were closed either by metallic clips or suturing.
After appropriate dissection of all potential hernia spaces medially from the symphysis pubis laterally to the psoas muscle and reduction of the hernia sac(s), a polypropylene mesh (Prolene, Ethicon, LCC) with a diameter of 15 �� 10cm was inserted and placed over the entire musculopectineal orifice with sufficient overlap at the medial and lateral borders. No keyhole over the mesh or no fixation of the mesh was being used. After the complete desufflation under permanent visual control of the operative area, removal of the trocars was performed. One fascial suture to subumbilical incision was applied. Skin incisions were closed in an appropriate manner. In case of difficulty or in the event of a complication, the operation was converted to Lichtenstein inguinal hernia repair in all cases.
2.2. Statistical Analysis Statistical calculations were performed using NCSS (Number Cruncher Statistical System, 2007) and PASS (Power Analysis and Sample Size) Statistical software (Utah, USA, 2008). Normally distributed continuous variables were expressed as mean �� standard deviation (SD). The range including minimum and maximum values was also added. Categorical variables were expressed as frequencies and percentages of an appropriate denominator. The Student’s t-test was used for analysis of normally distributed, descriptive continuous variables, which were expressed as mean �� SD. The Chi-Square Test and Fischer’s Exact Test were used to compare qualitative variables. Differences were considered statistically significant, if the P value was equal to or less than 0.
05. 3. Results The study group included 38 male and one female patient with 42 hernias. The mean age and body mass index of the patients were 48.8 �� 15.1 years (range from 19 to 73 years) and 26.2 �� 3.4kg/m2 (range from 19 to 32kg/m2), respectively. ASA classes I, II, and III distribution of the patients was 25, 15, and 2, respectively. There were 22 left- and 20 right-sided hernias. Indirect, direct, and combined hernias were present in 18, 12, and 12 cases, respectively. Hernias with previous repairs Entinostat were detected only in 4 cases. Peritoneal injury occurred in 9 cases (21.
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