Minimally Invasive Surgical Techniques for Inguinal Hernia Repair: The Extended-View Totally Extraperitoneal Approach (eTEP)

  • Jorge Daes


The extended-view totally extraperitoneal (eTEP) technique has evolved as a way to compensate for the disadvantages of working within a limited space. The eTEP technique is based on a better understanding of the abdominal wall anatomy and the notion that the extraperitoneal space is limitless once the confluence of the arcuate arch and semilunar line is taken down. The eTEP repair of inguinal hernias facilitates rapid and easy creation of the extraperitoneal space, a larger surgical field, a flexible port setup, tolerance to pneumoperitoneum, and good ergonomics. Overall, a sound extraperitoneal space for inguinal hernia repair that is compliant with the concept of the critical view of the myopectineal orifice is easier to establish. Many procedures have branched out from the eTEP concept, including eTEP lumbar neurectomy, eTEP lumbar hernia repair, the eTEP Rives-Stoppa technique, and eTEP transverse abdominis muscle release (TAR) for ventral hernia repair.


Extended-view TEP Inguinal hernia Laparoscopic Hernia repair eTEP Enhanced-view TEP Extraperitoneal technique 

Supplementary material

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Video 33.2

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Copyright information

© Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2019

Authors and Affiliations

  • Jorge Daes
    • 1
  1. 1.Minimally Invasive Surgery, Clínica PortoazulBarranquillaColombia

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