Primary Inguinal Hernia: TAPP

Transabdominal preperitoneal patch (TAPP) is indicated in bilateral primary hernia and recurrent inguinal hernia after the previous anterior approach. Recently, the key points of the techniques have been described and validated according to the criteria of evidence-based medicine (Oxford Classification) and are reported as the following: pneumoperitoneum induction, trocar placement, dissection, mesh placement and fixation, and peritoneal and trocar incision closure. In case of insecurity during the dissection, the TAPP technique allows, in contrary to TEP (total extraperitoneal patch plasty), the immediate view of intraperitoneal structures behind the flap thereby avoiding possible sectional or thermal damage.