What is laparoscopic TEP hernia repair?
TEP is a laparoscopic technique for treating inguinal and femoral hernias in which the operation is performed directly in the preperitoneal space.
During the operation, the surgeon:
- creates access to the preperitoneal space
- dissects the anatomical structures of the inguinal and femoral regions
- locates the hernia defect
- reduces the hernia contents
- dissects the hernia sac
- prepares the myopectineal orifice
- places a mesh implant
- ensures coverage of the inguinal and femoral canals
Unlike TAPP, in TEP *the abdominal cavity is not opened*, which avoids contact with the abdominal organs.
Our approach
At MSI, the hernia repair technique is chosen individually, taking into account the type and size of the hernia, the patient's anatomy, and any previous operations.
The TEP technique may be especially appropriate for:
- unilateral inguinal hernias
- bilateral inguinal hernias
- femoral hernias
- combined inguinal and femoral hernias
- primary hernias in patients suitable for a laparoscopic approach
During the operation, the entire *myopectineal orifice* is assessed, which allows potential hernia sites to be detected and closed.
Whenever possible, we prefer the minimally invasive approach, which reduces surgical trauma and speeds up recovery.
After surgery, the principles of *ERAS (Enhanced Recovery After Surgery)* are applied.
When is surgery needed?
Laparoscopic TEP hernia repair may be recommended for:
- indirect inguinal hernia
- direct inguinal hernia
- bilateral inguinal hernia
- femoral hernia
- combined inguinal and femoral hernia
- symptomatic inguinal or femoral hernia
- a hernia that is getting larger
- a hernia that causes pain or discomfort
Indications for surgery
Surgery is recommended for:
- pain
- an enlarging hernia bulge
- limited physical activity
- a symptomatic inguinal or femoral hernia
- bilateral inguinal hernias
- a combined inguinal and femoral hernia
- a risk of hernia complications
For an incarcerated hernia, the strategy is determined individually depending on the viability of the hernia contents and the need for additional surgery.
How is the operation performed?
The procedure is performed under general anesthesia.
Through a small incision near the navel, the preperitoneal space is created, and a laparoscope and special instruments are then inserted.
During the operation, the following are performed:
- creation of a preperitoneal working space
- identification of the anatomical structures
- dissection of the inguinal and femoral canals
- reduction of the hernia contents
- dissection of the hernia sac
- preparation of the myopectineal orifice
- placement of the mesh implant
- spreading the mesh with sufficient overlap of the hernia defects
For bilateral hernias, both sides can be repaired during a single operation.
Advantages of laparoscopic TEP hernia repair
- Minimally invasive approach
- No entry into the abdominal cavity
- Small skin incisions
- Less postoperative pain
- Early mobilization
- Shorter hospital stay
- Faster return to everyday activities
- Bilateral hernias can be treated in one operation
- Inguinal and femoral defects can be treated at the same time
- Reliable reinforcement of the entire myopectineal orifice
Laparoscopic treatment of bilateral hernias
One of the advantages of TEP is that bilateral inguinal hernias can be treated at the same time.
Both groins can be assessed and repaired during a single operation.
This avoids two separate operations and a second anesthetic.
Treatment of femoral hernias
TEP provides access to the entire myopectineal orifice and allows the femoral canal to be reliably covered with a mesh implant.
This is especially important for femoral hernias, which have a higher risk of incarceration.
When an inguinal and a femoral hernia occur together, both defects can be repaired during a single operation.
Recovery after surgery
TEP allows the patient to be mobilized quickly after surgery.
In the early postoperative period, the following are recommended:
- early walking
- pain control
- a gradual return to eating
- a gradual increase in physical activity
The length of recovery depends on the type of hernia, the extent of the operation, and the patient's individual characteristics.
A return to physical exertion takes place gradually, as advised by the surgeon.
Patient care follows the principles of *ERAS (Enhanced Recovery After Surgery)*.
Our advantages
- Experience in laparoscopic treatment of inguinal and femoral hernias
- Use of the modern TEP technique
- Treatment without entering the abdominal cavity
- Assessment and reinforcement of the entire myopectineal orifice
- Bilateral hernias can be treated in one operation
- Inguinal and femoral defects can be repaired at the same time
- Use of modern mesh implants
- Individual choice of technique and implant size
- A minimally invasive approach and fast postoperative recovery
- Enhanced recovery program (ERAS)
Frequently Asked Questions
The main difference is the approach. In TEP, the operation is performed in the preperitoneal space without entering the abdominal cavity, whereas in TAPP the surgeon first enters the abdominal cavity and then moves into the preperitoneal space.
Yes. With TEP, bilateral repair can be performed during a single operation.
Yes. The technique allows the femoral canal and other potential hernia sites to be closed.
Yes. A mesh implant is placed in the preperitoneal space and covers the myopectineal orifice.
It depends on the previous operation. After previous open hernia repair, the laparoscopic approach may be an effective option. After previous TEP or TAPP, an individual assessment is needed.
TEP avoids direct entry into the abdominal cavity, but like any surgical procedure, it carries certain risks. The technique is chosen individually after assessing the patient.
After an uncomplicated minimally invasive operation, mobilization is quick, and the return to everyday activities depends on the nature of your work and your individual recovery.
Yes. A return to physical exertion takes place gradually, after a postoperative check-up and as advised by the surgeon.