In this article, we describe a modified technique for laparoscopic ventral hernia repair that is easy to perform and teach. The three-keyhole process comprises two major steps: laparoscopic appreciation of the outlet dimension of the hernia and pin-tucking an appropriately sized polytetrafluoroethylene patch after the smooth face has been oriented toward the viscera. We report our experience of 231 patients who underwent the procedure electively between January 1997 and December 2001 with satisfactory results. We suggest that this method be used for all hernia defect-sized elective incisional hernias.
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