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Procedure · TEP & TAPP

Laparoscopic hernia repair.

Keyhole groin repair, with mesh placed behind the muscle wall to seal the weak area from inside. Less pain, an earlier return to activity, and the approach of choice when both sides are involved or a hernia has come back.

Laparoscopic repair fixes a groin hernia through three small keyhole incisions rather than one open cut. A sheet of mesh is placed behind the muscle wall, covering the weak area from inside, where the body's own pressure holds it flat against the defect. There are two routes to that same position — TEP and TAPP — and the result is a durable repair with, for most people, less pain and a quicker recovery than open surgery.

It is used mainly for inguinal and femoral hernias, and is particularly well suited to hernias on both sides and to those that have recurred after a previous open repair.

Who it suits

  • Hernias on both sides — both can be repaired through the same three incisions in one operation.
  • Recurrent hernias after a previous open repair, where keyhole surgery approaches fresh tissue from a different plane.
  • People who want the quickest return to physical work or sport.
  • Most fit patients suitable for a general anaesthetic.

It is less suitable when a general anaesthetic is best avoided, or after certain previous lower-abdominal or pelvic surgery — situations where open repair may be the better choice.

How it's done

TEP — totally extraperitoneal

The surgeon works in the layer just outside the abdominal cavity, without entering it. The hernia is reduced and mesh laid over the defect in that space. Because the abdomen is not entered, some prefer it where there has been previous abdominal surgery.

TAPP — transabdominal preperitoneal

The surgeon enters the abdomen, opens the lining over the hernia, places the mesh, and closes the lining back over it. The wider view can help with larger or more complex hernias and when the diagnosis needs confirming.

Both are sound. Ram performs both TEP and TAPP, as well as open and robotic repair, so the route is chosen from your hernia and history rather than from a single preferred technique.

Recovery

Keyhole repair is almost always day surgery — home the same day. Expect some bruising and a tight feeling in the groin for several days. Walking is encouraged immediately. Most people return to desk work within about a week and to heavier lifting and sport by three to four weeks. Driving resumes once an emergency stop can be done without hesitation.

Risks, honestly

Laparoscopic groin repair is safe and well established. The usual issues are bruising and seroma (a fluid collection that settles), and uncommonly some persistent discomfort. Recurrence after mesh repair sits in the low single figures. Because the repair is keyhole, it requires a general anaesthetic; the small risks of that are discussed beforehand. All of this is covered fully in consultation.

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Common questions

Laparoscopic repair — answered

Both place mesh behind the muscle wall. In TEP the surgeon works outside the abdominal cavity without entering it; in TAPP the surgeon enters the abdomen and approaches the hernia from inside. Both are durable — the choice depends on the hernia and any previous surgery.
Neither is universally better. Keyhole usually means less pain and an earlier return to activity, and is preferred for two-sided and recurrent hernias. Open repair suits a first single-sided hernia and can avoid a general anaesthetic.
Most people return to desk work within about a week and to heavier physical work by three to four weeks — usually quicker than after open repair.
Yes. Mesh is placed behind the muscle wall to seal the weak area from inside, which markedly lowers the chance of the hernia returning. The type and fixation are chosen for your anatomy.