Laparoscopic transabdominal pre-peritoneal (TAPP) repair of groin hernia: one surgeon's experience of a developing technique

Some 120,000 new cases of groin hernia are diagnosed each year in England, of which approximately 80,000 are referred to hospital for surgical repair.Around 40,000 trusses are sold annually, a number being wom by patients awaiting surgery.Bassini, one of the first to take advantage of the then modem developments of anaesthesia and asepsis, put hernia repair on a sound anatomical and scientific basis.He opened the inguinal canal, resected the hernial sac, and proceeded to complete anatomical reconstruction, particularly of the posterior wall.The results were then observed by follow-up, and recurrences recorded -the introduction to surgery of quality control and audit.In time, in the hands of experienced surgeons, the Shouldicel and Lichtenstein2 repairs achieved excellence, and low recurrence rates.These methods all involved an anterior approach.Ger3 first reported the laparoscopic closure of a hernial sac using a dip.Subsequently, a number of laparoscopic operations were described, but most proved unsatisfactory when subjected to