Totally Extraperitoneal Repair of Hernia Lecture by Dr. R.K. Mishra
 
Totally extraperitoneal (TEP) repair is a laparoscopic surgical technique for repairing inguinal hernias. This technique involves creating a space between the peritoneum and the abdominal wall, through which a mesh is placed to reinforce the weakened area and prevent the hernia from recurring.
 
TEP repair is gaining popularity over traditional open surgery due to several advantages, including reduced pain, faster recovery, and lower risk of complications such as infection and nerve damage.
 
In TEP repair, the patient is placed under general anesthesia and positioned in the supine position. Several small incisions are made in the abdominal wall, and a laparoscope and other surgical instruments are inserted to create the extraperitoneal space. The peritoneum is then gently lifted away from the abdominal wall, creating a space for the mesh to be inserted. The mesh is placed over the weakened area, and its edges are secured to the surrounding tissue using sutures, tacks, or clips.
 
After the mesh is placed, the laparoscope and surgical instruments are removed, and the small incisions are closed using sutures or surgical glue. The patient is then monitored in the recovery room before being discharged the same day or the following day. TEP repair offers several advantages over open surgery, including reduced postoperative pain and shorter recovery time. In addition, TEP repair is associated with a lower risk of complications such as infection, bleeding, and nerve damage.
 
However, TEP repair also requires specialized training and expertise, and not all surgeons are qualified to perform this technique. Patients should consult with their surgeon to determine whether TEP repair is appropriate for their specific case.
 
In conclusion, totally extraperitoneal (TEP) repair is a laparoscopic surgical technique for repairing inguinal hernias that offers several advantages over traditional open surgery. TEP repair is associated with reduced pain, faster recovery, and lower risk of complications, but requires specialized training and expertise. Patients should consult with their surgeon to determine the best approach for their specific case.