Laparoscopic Extraperitoneal Treatment of Inguinal Hernia

Inguinal hernia repair is one of the most commonly performed surgical procedures around the world. In 1887, Bassini first introduced the modern concept of surgical hernia repair, and since then, with the aim to improve postoperative outcomes, several surgical techniques and approaches have been proposed. The most important innovation was undoubtedly the tension-free hernioplasty concept with the use of a prosthetic mesh proposed by Lichtenstein. This technique provided better postoperative results in comparison with the previous tension hernioplasty described in terms of pain, discomfort, and recurrence rate. Although maintaining the tension-free hernioplasty concept, the introduction of the minimally invasive approach for inguinal hernia repair was another important innovation. Minimally invasive inguinal hernia repair can be performed by two techniques: transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair. Currently, these two techniques are equivalent in terms of postoperative outcomes such as pain, complications, hospital stay, return to daily activities, and recurrence rate. The aim of this chapter is to report the surgical instruments required and describe the surgical technique to perform the laparoscopic TAPP repair of inguinal hernia.