Left-sided Transabdominal Preperitoneal (TAPP) inguinal hernia repair is one of the most refined minimally invasive procedures in modern hernia surgery. Under the guidance and expertise of celebrated laparoscopic surgeon Dr. R.K. Mishra, the TAPP technique has become a standardized, safe, and effective approach for treating inguinal hernias with precision. His method focuses on anatomical clarity, meticulous dissection, and secure mesh placement, ensuring reduced postoperative pain and quicker recovery for patients.

The procedure begins with the creation of pneumoperitoneum and insertion of trocars in a systematic triangular arrangement to allow optimal visualization of the left inguinal region. Dr. Mishra emphasizes the importance of a clear laparoscopic view of key landmarks such as the inferior epigastric vessels, Cooper’s ligament, spermatic cord structures, and the hernia defect. These structures guide the surgeon in performing controlled peritoneal incision and accessing the preperitoneal space where the hernia sac lies.

Dissection is one of the most crucial phases of TAPP repair. Dr. Mishra’s step-by-step technique ensures gentle reduction of the hernia sac while preserving vital structures like the vas deferens and testicular vessels. The surgeon carefully separates the sac from surrounding tissues, especially in indirect hernias where the sac may be elongated or adherent. By maintaining a bloodless field and respecting anatomical planes, the risk of complications is significantly minimized.

Once the hernia sac is fully reduced, a large polypropylene or lightweight mesh is placed in the preperitoneal pocket. Dr. Mishra advocates for wide coverage of all potential hernia zones—direct, indirect, and femoral—to prevent recurrence. The mesh is either fixed with tackers or placed without fixation depending on surgeon preference and patient anatomy. The final step involves meticulous closure of the peritoneal flap to prevent mesh exposure to abdominal contents and reduce postoperative adhesions.

Dr. Mishra’s TAPP approach is admired for its clarity, precision, and adherence to safe laparoscopic principles. Through structured steps, thorough understanding of anatomy, and emphasis on minimal tissue trauma, the technique offers excellent outcomes and faster patient recovery. As laparoscopic surgery continues to evolve, his contribution to standardized training and teaching has empowered surgeons worldwide to perform TAPP inguinal hernia repair with confidence and consistency.