Laparoscopic hernia repair: the anatomic basis

Laparoscopic hernia repair offers the potential for more rapid recovery in patients compared with standard anterior herniorrhaphy. Whether the procedure can be performed safely and effectively has yet to be determined. Long-term success will depend on the ability to adhere to the basic principles of traditional hernia repair, maintain low recurrence rates, and achieve rapid return of the patient to work. Inguinal anatomy as viewed through the laparoscope is unfamiliar to most surgeons. The potential for complications requiring laparotomy is increased with laparoscopic hernia repair and dissection in this region requires precise knowledge of the anatomic relationships. Photographic representations of cadaver dissections of the intra-abdominal inguinal region are displayed, and detailed descriptions applicable anatomic structures are presented. A laparoscopic approach for the repair of inguinal and femoral hernia is provided, based on sound comprehension of anatomic relationships.