A. Midline Placement
used for bilateral Hernia Repair and unilateral Hernia Repair when operating alone
surgeon stands on contralateral side

Advantage
laparoscope, instruments and video monitor are all in line in front of surgeon
working trocars can be safely placed with no manual dissection

Disadvantage
suprapubic trocar can be covered by mesh placement
if this occurs, a lateral trocar can be inserted to facilitate a mesh placement

1. First trocar balloon dissection device place infraumbilical.
2. Second trocar is 10-12mm placed in midline at level of iliac crest.
3. Third trocar is 5mm placed three finger breadths above pubic symphasis.

B. Lateral Placement
used for unilateral hernia repair working with an assistant
surgeon stands on contralateral side

Advantage
easier mesh placement

Disadvantage
assistant must provide proper counter traction
space must be dissected free to place lateral trocar

1. first trocar is balloon dissection device place infraumbilical
2. second trocar is 10-12mm placed in midline at level of iliac crest
3. third trocar is 5mm placed lateral to rectus muscle on ipsilateral side at level of iliac crest