ZenToks Publication

Chapter 24

The Total Extraperitoneal Inguinal Hernia Repair: A Review

Abstract/Preface

Inguinal hernia repair ranks among the most frequently performed surgical procedures globally. The advent of minimally invasive techniques has markedly transformed the surgical management of groin hernias, with Total Extraperitoneal (TEP) repair being recognized as a well-established laparoscopic method. Unlike the transabdominal preperitoneal (TAPP) repair, TEP is conducted entirely within the extraperitoneal space, thereby avoiding entry into the peritoneal cavity. This technique minimizes the risk of intra-abdominal complications, such as bowel perforation and vascular injuries. Numerous studies have indicated that TEP repair achieves recurrence rates comparable to those of open mesh repair, while providing benefits such as reduced postoperative pain, quicker resumption of normal activities, and lower incidences of chronic groin pain. Nevertheless, the procedure presents a steeper learning curve due to the restricted working space and the complex anatomy of the posterior groin. This chapter explores TEP repair, focusing on its indications, mesh fixation methods, and comparisons with TAPP and other open inguinal hernia repair techniques.