Journal Basic Info

  • Impact Factor: 1.995**
  • H-Index: 8
  • ISSN: 2474-1647
  • DOI: 10.25107/2474-1647
**Impact Factor calculated based on Google Scholar Citations. Please contact us for any more details.

Major Scope

  •  Neurological Surgery
  •  Minimally Invasive Surgery
  •  Thoracic Surgery
  •  Gastroenterological Surgery
  •  Obstetrics Surgery
  •  Emergency Surgery
  •  Surgical Oncology
  •  General Surgery


Citation: Clin Surg. 2017;2(1):1698.Short Communication | Open Access

Artificial Arcuate Line: Surgical Creation during TEPP Hernioplasty

Maulana M Ansari

Department of Surgery, J. N. Medical College, Aligarh Muslim University, Aligarh, UP, India

*Correspondance to: Maulana Mohammed Ansari 

 PDF  Full Text DOI: 10.25107/2474-1647.1698


Level and technique of entry into the preperitoneal space during Total Extraperitoneal Preperitoneal (TEPP) hernioplasty is always a matter of dilemma, differing markedly among the experts across the globe. In presence of long posterior rectus sheath with low arcuate line of Douglas and complete posterior rectus sheath with absent arcuate line, a transverse cleavage in the posterior rectus sheath was surgically made at or just below the mid-point of the umbilico-pubic distance to mimic the classical arcuate line in order to keep the ‘effective rectus sheath canal’ to within 2 cm for optimal surgeon’s ergonomics, excellent endoscopic vision, and ample working space. The level of the transverse cleavage in the posterior rectus sheath, i.e., surgical creation of the artificial arcuate line, corresponded to the level of the middle working port in the 3-midline-port technique of TEPP hernioplasty, and proved extremely rewarding without failing and is strongly recommended.


Arcuate line; Artificial arcuate line; TEPP hernioplasty; Low arcuate line; Absent arcuate line; Long posterior rectus sheath; Complete posterior rectus sheath

Cite the article

Ansari MM. Artificial Arcuate Line: Surgical Creation during TEPP Hernioplasty. Clin Surg. 2017; 2: 1698.

Search Our Journal

Journal Indexed In

Articles in PubMed

Monitoring an Ongoing Enhanced Recovery after Surgery (ERAS) Program: Adherence Improves Clinical Outcomes in a Comparison of Three Thousand Colorectal Cases
 PubMed  PMC  PDF  Full Text
Risk Factors for Visual Impairment in an Uninsured Population and the Impact of the Affordable Care Act
 PubMed  PMC  PDF  Full Text
View More...

Articles with Grants

Preoperative Intra-Aortic Balloon Pump Inserted in Acute Myocardial Infarction Patients without Cardiogenic Shock Undergoing Surgical Coronary Revascularization
 Abstract  PDF  Full Text
Correlation between Characteristics of Lymph Node Metastasis and Prognosis of N1-N2 Stage Non-small Cell Lung Cancer
 Abstract  PDF  Full Text
View More...