Watch this detailed video on Laparoscopic Inguinal Hernia Repair TAPP – Skin to Skin Procedure, demonstrating the complete surgical steps from initial skin incision to final closure. This educational video explains trocar placement, peritoneal dissection, mesh placement, and fixation techniques used in TAPP hernia repair.

This video is designed for surgeons, surgical trainees, and medical professionals who want to understand the practical approach, anatomical landmarks, and safe surgical principles involved in laparoscopic inguinal hernia repair.

Laparoscopic TAPP repair is one of the most commonly performed minimally invasive methods for inguinal hernia repair. In this technique, small skin incisions are made to insert a camera and working instruments, allowing the surgeon to access the hernia through the abdominal cavity. The hernia defect is repaired by placing a synthetic mesh in the preperitoneal space to reinforce the myopectineal orifice and prevent recurrence. The skin-to-skin concept refers to the complete operative workflow — starting from skin incision, trocar placement, intra-abdominal dissection, mesh placement, peritoneal closure, port removal, and final skin closure.

The goal is a safe, reproducible, and standardized minimally invasive procedure with excellent anatomical visualization and precise repair. Stepwise Surgical Concept (Skin to Skin) 1. Patient Preparation and Port Placement The procedure is usually performed under general anesthesia. After creating pneumoperitoneum, 3 small ports are inserted.

This minimally invasive access reduces postoperative pain and allows faster recovery compared to open repair. 2. Diagnostic Laparoscopy and Peritoneal Flap Creation The surgeon inspects both groins and creates a peritoneal incision to enter the preperitoneal space.

This step allows identification of occult or bilateral hernias. 3. Preperitoneal Dissection Dissection is performed to expose key landmarks such as inferior epigastric vessels, Cooper’s ligament, and cord structures, ensuring adequate space for mesh placement. 4. Hernia Sac Reduction and Mesh Placement The hernia sac is reduced, and a large mesh is placed to cover all potential hernia sites. Mesh integration with surrounding tissue reduces recurrence risk. 5. Peritoneal Closure The peritoneal flap is closed over the mesh to isolate it from intra-abdominal organs, which is a key step unique to TAPP. 6. Port Removal and Skin Closure After hemostasis and desufflation, trocars are removed and skin is closed, completing the skin-to-skin workflow. Advantages of TAPP Approach Excellent visualization of anatomy and contralateral side Useful in bilateral, recurrent, or complicated hernias Allows identification of hidden defects Familiar laparoscopic anatomy for surgeons (shorter learning curve compared to TEP) Clinical Significance Laparoscopic inguinal hernia repair techniques such as TAPP and TEP are now widely accepted as standard minimally invasive options because of smaller incisions, faster recovery, and less chronic pain compared with traditional open surgery.

Conclusion Laparoscopic TAPP inguinal hernia repair performed as a skin-to-skin procedure represents a structured, safe, and effective minimally invasive surgery. With proper patient selection and surgical expertise, it provides excellent anatomical repair, early recovery, and durable outcomes, making it an important technique in modern hernia surgery.