In the Stoppa (preperitoneal giant prosthetic reinforcement of the visceral sac, GPRVS) procedure for bilateral inguinal hernia repair, the large mesh is placed in which anatomical space?

• A Anterior to the external oblique aponeurosis
• B Retropubic space of Retzius and preperitoneal space of Bogros ✓
• C Within the inguinal canal superficial to the spermatic cord
• D Intraperitoneal space directly overlying the peritoneum

Explanation

The Stoppa procedure uses a large bilateral preperitoneal prosthesis placed in the preperitoneal space — specifically the space of Retzius (retropubic) anteriorly and the space of Bogros laterally. The mesh covers both myopectineal orifices, reinforcing all potential hernia defects bilaterally without the need for fixation sutures (intraabdominal pressure holds it in place). This is the anatomical basis for laparoscopic TEP (total extraperitoneal) and TAPP (transabdominal preperitoneal) repairs, which reproduce the Stoppa principle endoscopically.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.