Like many other advancements in minimally invasive surgery, the concept of enhanced-view totally extraperitoneal (eTEP) access was developed outside of traditional surgical academic centers. In 2009, while trying to find ways to facilitate the TEP approach for inguinal hernia repair mainly for teaching purposes, we observed that entering the retrorectus space from afar the hernia site overcame most of the drawbacks of the traditional TEP approach (namely, the limited surgical field, constrained port setup, low tolerance to accidental pneumoperitoneum, poor ergonomics, and difficulty teaching and learning the technique). We tried to publish our early results but met with skepticism. We finally published the results of a series of inguinal hernia repairs, many of them in complex cases, in 2011 [1–3]. We soon noticed that the surgical space was ideal for the repair of other abdominal hernias. In early 2005, we published reports on eTEP repair of Spigelian, low midline (M5), and lumbar (L4) hernias (using direct access to the preperitoneal space from lateral to the semilunar line) [4]. In September 2015, Belyansky [5] reported the “crossover” maneuver as a way to cross from one retrorectus space to the other. A historical picture of the first published eTEP crossover performed in a patient with a previous biologic mesh is shown in Fig. 3.1. This pioneering contribution revolutionized the repair of ventral, incisional, and lumbar hernias.