ABSTRACT
Ideal patients for an extraperitoneal approach are those who have not had an abdominal incision, particularly a midline incision.
● A disposable balloon device is first inserted anterior to the posterior rectus sheath through a small infraumbilical incision. The balloon is distended with water or air using a bulbar syringe to dissect the anterior peritoneum from the overlying rectus muscle.This is usually done under direct vision. In those with previous midline operation scar, scarring will cause the balloon to dissect on one side of the retropubic space and potentially rupture the underlying peritoneum and/or the balloon.
