Extraperitoneal laparoscopic inguinal hernia repairs

Totally extraperitoneal herniorrhaphy (TEP) is a highly technical procedure with a long learning curve for surgeons. It demands extra skills and may be frustrating, even to the experienced laparoscopic surgeon. The main eriticisms have been the higher costs, the need for general anesthesia, and the prolonged operating room time. When properly performed, TEP provides satisfaction to all involved, namely the patient, the surgeon and the third party payer. The initial concerns of safety, efficacy and efficiency are no longer valid issues as TEP has proved to be safe in numerous randomized trials. We find that there is increasing patient demand for this procedure.