Totally Extraperitoneal Endoscopic Inguinal Hernia Repair (TEP)

Abstract

There is no doubt that surgical techniques using mesh result in fewer recurrences than techniques that do not use mesh. The open Lichtenstein and endoscopic inguinal hernia techniques are the best studied. Endoscopic hernia repair can be performed by TAPP (TransAbdominal PrePeritoneal) or TEP (Totally ExtraPeritoneal) technique. Both minimally invasive techniques follow the principle of Stoppa, who promoted a giant prosthetic reinforcement of the abdominal wall in the preperitoneal plane in order to cover the whole myopectineal orifice on both sides. We prefer TEP since it preserves peritoneal integrity, although it is more difficult to learn because of the limited working space and a different appreciation of the usual anatomical landmarks.