PMC2883827_01
The undisturbed view of the structures visualised in the right iliac fossa at diagnostic laparoscopy. The greater omentum overlies the appendix and peritonealised Mesh and is clearly seen to be attached to the anterior abdominal wall. The black arrows identify the omental adhesions to the anterior abdominal wall that follow a line corresponding to the peritoneal closure from the TAPP repair. P.A.C. = Proximal Ascending Colon; Om. = Omentum
JMAS-06-19-g001.jpg
PMC2883827_01_JMAS-06-19-g001.jpg
F0001
TAPP repair [Figure 1].
View of turgid appendix, overlying, and attached to, the peritonealised Mesh revealed after division of the covering omentum using bipolar diathermy. The omentum was adherent superiorly along a line corresponding to the line of peritoneal overlap and/or imperfectly covered areas of Mesh that may result after TAPP repair. * = Appendix adherent to peritonealised Mesh; # = peritonealised Mesh;   = Remnant of omentum left attached to the anterior abdominal wall;   = Caecum;   = Terminal ileum
JMAS-06-19-g002.jpg
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F0002
The omental adhesiolysis in the right iliac fossa revealed a small amount of free fluid and a turgid appendix overlying and adherent to the peritonealised Mesh from the previous right laparoscopic inguinal herniorraphy [Figures 2 and 3]. The turgid appendix was carefully dissected off the peritonealised Mesh using sharp and blunt dissection; again taking care not to expose the underlying Mesh.
Close up image acquired with the video-endoscope zoom facility illustrating adhesions between the turgid appendix and peritonealised Mesh. * = Appendix adherent to peritonealised Mesh; # = peritonealised Mesh;   = Remnant of omentum left attached to the anterior abdominal wall;   = Caecum;   = Terminal ileum
JMAS-06-19-g003.jpg
PMC2883827_01_JMAS-06-19-g003.jpg
F0003
The omental adhesiolysis in the right iliac fossa revealed a small amount of free fluid and a turgid appendix overlying and adherent to the peritonealised Mesh from the previous right laparoscopic inguinal herniorraphy [Figures 2 and 3]. The turgid appendix was carefully dissected off the peritonealised Mesh using sharp and blunt dissection; again taking care not to expose the underlying Mesh.