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“PK Band” in Laparoscopic Hernia Repair

PK Band in Laparoscopic Hernia Repair

Ramakrishnapillai, P., Gupta, S., Pai, M. et al. “PK Band” in Laparoscopic Hernia RepairIndian J Surg (2020). https://doi.org/10.1007/s12262-020-02088-z

Abstract

Laparoscopic inguinal anatomy detail is different from that is necessary for open hernia surgery. ‘PK Band’ is a condensation of areolar tissue lateral to inferior epigastric vessels on either side. It extends from arcuate line to apex of triangle of doom. It is more condensed and prominent in the upper part. ‘PK Band’ is more prominent in males and tall structured individuals. It is an important land mark during laparoscopic inguinal dissection in both TEP (total extra peritoneal) and TAPP (trans abdominal preperitoneal) methods. Lateral blunt dissection in the preperitoneal plane will definitely be restricted by this band. Forcing the scope laterally will cause tear of the peritoneum at that level. Muscle injury may also be caused by blunt dissection. Division of this band during laparoscopic hernia repair connects the space of Bogros with space of Retzius. This provides sufficient space necessary for proper placement of mesh and hence significantly reduce recurrence.


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References

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Author information

Affiliations

  1. Department of General & Laparoscopic Surgery, VPS Lakeshore Hospital, Kochi, India
    • Padmakumar Ramakrishnapillai
    • , Sandeep Gupta
    • , Madhukara Pai
    • , Aravind Balakrishnan
    • , Kevin J Chiramel
    •  & Premna Subin
  2. VSM Hospital, Mavelikkara, India
    • Farish Shams
  3. Verwandeln Institute, Kochi, Kerala, 682306, India
    • Subin Thomas

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Contact Details

Dr. R. Padmakumar
MBBS, DNB, MNAMS, DipALS, FAIS, FIMSA, FCLS, FRCS (GL)
Senior Consultant Laparoscopic and Metabolic Surgeon &
Director - Verwandeln Institute (Transforming Lives)
(Specialist in Laparoscopy, Hernia, Cancer, Obesity Surgery or Bariatric Surgery, Diabetes Surgery, Endoscopic Thyroid Surgery, Thoracoscopy, Intragastric Balloon)
Keyhole Clinic, Metro Pillar no. 448, Edappally, Kochi, Kerala, India
VPS Lakeshore Hospital, Maradu, Kochi, Kerala, India
Past Chairman - Association of Surgeons of India, Kerala Chapter, 2019-2020

Address

Keyhole Clinic - Center for Obesity and Laparoscopy

Metro Pillar no. 448, Edappally, Kochi, Kerala, India

VPS Lakeshore Hospital

Maradu, Kochi, Kerala


Mobile: +919447230370, +919846320370
Email: [email protected]

Website:
www.drrpadmakumar.com

Past Chairman, Association of Surgeons of India - Kerala Chapter
National President - Indian Hernia Society (2016)
GC Member, Association of Surgeons of India (2013 - 2018)
Vice President- Society of Endoscopic and Laparoscopic Surgeons of India
Jt. Secretary - Indian Association of Endocrine Surgeons (2016)
Founder Member, Obesity and Metabolic Surgery Society Of India
Founder Member, Association of Minimal Access Surgeons of India
International Faculty of IASGO on Hernia and Diabetic Surgery
International Faculty of IFSO on Diabetic Surgery
Associate Editor : Diabetes and Obesity International Journal