How I Repair Inguinal Hernias: A Patient’s Guide to Laparoscopic TEP Surgery
If you’ve been diagnosed with an inguinal hernia, you’re not alone — it’s a common condition where a portion of tissue or intestine protrudes through a weak spot in the abdominal wall near the groin.
To repair this, I use a minimally invasive technique called laparoscopic TEP (Totally Extraperitoneal) repair, which offers quicker recovery and less discomfort compared to traditional open surgery.
In TEP surgery, I make three small incisions below the belly button.
Using a camera and specialized instruments, I access the space between the abdominal wall and the peritoneum (the lining of the abdominal cavity) without entering the abdominal cavity itself.
This approach reduces the risk of internal organ injury and postoperative complications.
Covidien DP2 Mesh
This is a lightweight, large-pore, monofilament mesh made of polyester, designed to conform to the natural shape of the groin. It is coated with a hydrogel layer to improve handling and reduce friction during placement. The mesh strengthens the weakened area and reduces the risk of the hernia returning.
AbsorbaTack Fixation Device
To hold the mesh in place, I use absorbable tacks made from a biocompatible copolymer (glycolide, lactide, and trimethylene carbonate). These gradually dissolve over time, avoiding permanent foreign materials and helping reduce long-term discomfort.
Minimally Invasive – Smaller incisions mean less pain and faster recovery.
Lower Risk of Organ Injury – By staying outside the abdominal cavity, the chance of damaging internal organs is reduced.
Temporary Fixation – Absorbable tacks secure the mesh during healing but don’t remain in the body permanently.
If you are coming to me for recurrent inguinal hernia repair after previously having surgery — particularly if mesh was used — I adjust the surgical approach to reduce your risk of complications and improve the likelihood of a successful repair.
If your original repair was open, I will usually recommend a laparoscopic repair.
If your original repair was laparoscopic, I may opt for an open repair.
This strategy allows me to operate in a new, undisturbed tissue plane, avoiding scar tissue and previously placed mesh.
By working in a “fresh” area, we reduce the risk of nerve damage, chronic pain, and infection, and increase the chances of achieving a strong, durable repair.
While laparoscopic TEP repair is generally safe, all surgery carries some risks. These may include:
Bleeding or Infection – Especially at incision or mesh sites.
Chronic Pain – A small number of patients may develop persistent groin discomfort.
Hernia Recurrence – The hernia may return, particularly if the mesh doesn’t integrate properly.
Injury to Nerves or Blood Vessels – Rare, but can occur during dissection.
Mesh Infection – Although uncommon, infections involving mesh may require antibiotics or further surgery.
Injury to Internal Organs – Including the bowels or bladder, though this is rare.
Conversion to Open Surgery – If unexpected complications arise or visibility is poor, the procedure may need to be completed through a larger, open incision.
Anesthesia Risks – These include allergic reactions or breathing issues, which are rare but important to consider.
Choosing the right surgical technique is key to a successful hernia repair — especially for recurrent hernias.
My goal is always to perform a safe, effective, and durable repair while minimizing your risk of complications.
If you’re considering surgery, or have questions about your previous hernia repair, feel free to bring them up during your consultation. We’re here to help you understand your options and make informed decisions about your care.
© Dr. Leong Tiong. All rights reserved.