Laparoscopic Inguinal Hernia Repair: TAPP

Two laparoscopic techniques for laparoscopic inguinal hernia repair are used currently: a totally extraperitoneal technique (TEP) and a transabdominal preperitoneal technique (TAPP). In TAPP, the peritoneum is incised to gain access to the preperitoneal space, and similar surgical steps are performed in both techniques: hernia content reduction, treatment of hernial sac, and placement of preperitoneal mesh. Nowadays, it is accepted that TEP is preferred over TAPP because the TEP technique has a lower rate of trocar-site hernias and intra-abdominal injuries. However, TEP is a more demanding and complex technique, with a higher learning curve. For laparoscopic inguinal hernia repair, the TAPP intervention should be learned as a first step. TEP has a steeper learning curve, and after mastering TEP, performing TAPP will come easily.