Special Situations in Operations for Groin Hernias by Total Extraperitoneale coelioscopique Approach (TEP)

The posterior approach to the entire myopectineal orifice of Fruchaud via an abdominal incision with the insertion of a large prosthesis completely overlapping all orifices has been popularised by Stoppa since 1980. Since 1990, the Stoppa technique has been performed endoscopically, by means of both the transperitoneal (TAPP) and preperitoneal (TEP) approaches.In 2009, the European Hernia Society published evidence-based guidelines for the treatment of inguinal hernias. Grade A recommendations: for the repair of recurrent hernias after conventional open repair, endoscopic inguinal hernia techniques are recommended. When only considering chronic pain, endoscopic surgery is superior to open mesh. It is recommended that an endoscopic technique is considered if a quick postoperative recovery is particularly important. From a socio-economic perspective, an endoscopic procedure is proposed for the active working population, especially for bilateral hernias.These recommendations may seem paradoxical because it is illogical to recommend the use of this technique to surgeons not particularly pulled in this procedure. Nevertheless, as the advantages of the laparoscopic approach are recognized as being the best, why shouldn’t we recommend it for all patients?Thus, for an experimented surgeon, TEP could be a Gold Standard for any cases, easy or difficult.