“PK Band” in Laparoscopic Hernia Repair

Ramakrishnapillai, P., Gupta, S., Pai, M. et al. “PK Band” in Laparoscopic Hernia Repair. Indian 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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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