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The totally extraperitoneal hernioplasty (TEP) is one of the wide application field range of the PAJUNK® Eco-/Dispo balloon systems. Instead of the – otherwise necessary – peritoneal opening, access is ensued through a small incision. Accordingly small is the wound area and the risk of infection. This reduces, compared to endoscopic dissection, the need for post-surgical pain medication 1) as well as the rate of complications.2)

Exemplary presentation of retroperitoneal dissection of tissue layers with the PAJUNK® Eco-/Dispo balloon system:

The dilation balloon is introduced by means of a blunt obturator parallel to the peritoneum.
The obturator is retracted and can be replaced by a laparoscope.
Practitioners are advised to place a structural or ring-anchor balloon system to ensure working space access. Carbon dioxide is then injected to maintain the preperitoneal space during the operation.

Further application areas of the PAJUNK® balloon systems:

Spinal surgery

This technique can be used supportively in lumbar spine procedures with anterior access. The balloons can be used to dilate the operating space between two access points. 3)

Lymph node removal

Here, the balloon creates space for minimally invasive instruments. This allows the benefits of minimally invasive access techniques to be transferred to lymph node removal procedures.4)


Balloon dilation is also useful in surgery on the kidneys, ureters and other organs located in the retroperitoneal area, as it allows space to be created for the procedure.

Creation of retroperitoneal space for spinal surgery.

Examples of uses.

Creation of retroperitoneal space for urological kidney surgery.

1) Misra, Kumar, Bansal, Total extraperitoneal (TEP) mesh repair of inguinal hernia ..., 2008; 1

2) Misra, Kumar, Bansal, Total extraperitoneal (TEP) mesh repair of inguinal hernia ..., 2008; 7

3) Hannon et al., Comparison of insufflation vs retractional technique ..., 2000; 14: 304

4) Brunt et al., Endoscopic Axillary Lymph Node Dissection ..., 1998; 10(4): 162

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