This video demonstrate laparoscopic repair of Laparoscopic Inguinal Hernia Fully Explained Step by Step by Dr R K Mishra. The transabdominal preperitoneal (TAPP) approach is the most frequently used laparoscopic technique for inguinal hernia repair. In this video, key steps of the procedures are demonstrated.

Laparoscopic inguinal hernia repair is one of the most advanced and widely accepted minimally invasive surgical procedures used to treat inguinal hernia. At World Laparoscopy Hospital (WLH), this surgery is performed and taught using standardized, evidence-based protocols under expert supervision, ensuring safety, precision, and excellent patient outcomes. The procedure mainly includes two approaches: TAPP (Transabdominal Preperitoneal Repair) and TEP (Totally Extraperitoneal Repair), both designed to repair the hernia defect and reinforce the inguinal region with mesh.

Introduction to Laparoscopic Inguinal Hernia Repair

Inguinal hernia occurs when abdominal contents protrude through a weak point in the abdominal wall in the groin region. Laparoscopic repair involves using small incisions, a camera, and specialized instruments to repair the defect internally. Compared to open surgery, it usually results in less postoperative pain, faster recovery, smaller scars, and earlier return to normal activity.

At World Laparoscopy Hospital, surgeons are trained to follow precise anatomical dissection principles and ergonomic laparoscopic techniques, ensuring minimal complications and low recurrence rates.

Step-By-Step Surgical Procedure

Step 1: Patient Preparation and Positioning

• The patient is placed in a supine position under general anesthesia.

• A slight Trendelenburg position is given to move intestines away from the pelvis for better visualization.
  This helps create an optimal surgical field and reduces risk of injury.

Step 2: Port Placement

• Typically, three ports are inserted:

  • One 10 mm camera port at the umbilicus

  • Two 5 mm working ports on either side

• Proper port triangulation allows smooth instrument movement and clear visualization of the inguinal anatomy.

Step 3: Creation of Peritoneal Flap (TAPP Technique)

• A peritoneal incision is made above the internal ring.

• The peritoneum is dissected to create access to the preperitoneal space.

• Important anatomical landmarks are identified:

  • Inferior epigastric vessels

  • Vas deferens

  • Testicular vessels

  • Cooper’s ligament
    Careful dissection prevents vascular or nerve injury.

Step 4: Hernia Sac Dissection

• The hernia sac is identified and separated from surrounding structures.

• Indirect hernia sac is reduced from spermatic cord structures.

• Direct hernia sac is flattened and reduced.
  This ensures proper preparation for mesh placement and reduces recurrence risk.

Step 5: Mesh Placement

• A polypropylene or lightweight mesh (usually about 10 × 15 cm) is placed.

• The mesh covers the entire myopectineal orifice, preventing direct, indirect, and femoral hernia recurrence.
  Mesh must lie flat and tension-free for optimal outcomes.

Step 6: Mesh Fixation

• Mesh may be fixed using tackers, glue, or self-fixating mesh.

• Surgeons avoid fixation near nerves and vessels to prevent chronic postoperative pain.

Step 7: Closure of Peritoneum

• The peritoneal flap is closed using sutures or tacks to cover the mesh.

• This prevents bowel adhesion to the mesh and restores peritoneal integrity.

• Ports are removed and fascial defects are closed to prevent port-site hernia.

Postoperative Care and Recovery

• Early ambulation is encouraged.

• Discharge is often same day or next day.

• Light activity may resume within 48 hours and full activity usually within a few weeks.

Advantages of Laparoscopic Repair

• Minimal postoperative pain

• Faster recovery and early return to work

• Better cosmetic results

• Ability to detect and repair bilateral hernias simultaneously

• Lower wound complication rates

Why World Laparoscopy Hospital is a Global Leader

World Laparoscopy Hospital is internationally recognized for laparoscopic and robotic surgical training. Surgeons from many countries undergo structured hands-on training programs, simulation-based learning, and live surgical exposure under expert mentors. The hospital emphasizes safe surgical principles, advanced technology, and evidence-based practice.

Conclusion

Laparoscopic inguinal hernia repair represents a major advancement in modern surgery. With step-by-step standardized techniques such as TAPP and TEP, surgeons can achieve excellent outcomes with minimal patient discomfort. At World Laparoscopy Hospital, this procedure is performed and taught with world-class expertise, making it a preferred center for both patient care and surgical education.