# Laparoscopic Hernia Repair

> Citation bundle for Laparoscopic Hernia Repair on The Treatment Registry.
> URL: https://thetreatmentregistry.com/procedures/hernia-repair-lap
> Bundle URL: https://thetreatmentregistry.com/api/citations/procedures/hernia-repair-lap

- Category: general-surgery
- Average recovery: 10 days
- Typical sessions: 1
- Price range (USD international): $2,500–$7,500

## Description

Laparoscopic hernia repair is a minimally invasive technique in which the hernia defect is approached from inside the abdominal wall using small ports and a camera, with mesh placed in the preperitoneal space to reinforce the defect. The two main variants are transabdominal preperitoneal (TAPP) repair, which enters the abdominal cavity, and totally extraperitoneal (TEP) repair, which dissects the preperitoneal space without entering the peritoneum. Compared to open repair, laparoscopic approaches offer faster return to normal activity, lower acute pain, and better cosmesis — at the cost of a longer operative time, the requirement for general anaesthesia, and a steeper learning curve for the surgeon.

## Overview

Laparoscopic hernia repair was developed in the 1990s and has become the preferred approach for bilateral and recurrent inguinal hernias per NICE TA160. For primary unilateral inguinal hernias, NICE supports both open and laparoscopic approaches; surgeon experience and patient preference drive the choice. The Cochrane review of open vs laparoscopic mesh repair (2018) shows comparable recurrence rates but significantly less chronic post-operative pain with the laparoscopic approach in experienced hands.

## Peer-reviewed outcome rates

- **Complication rate:** 4.00% (range 2.00–8.00%) — from 1 cited source
- **Revision rate:** 2.00% (range 1.00–5.00%) — from 1 cited source

## Common risks

- Recurrence
- Chronic post-operative pain
- Bowel or bladder injury (rare)
- Seroma
- Mesh infection (rare)
- Trocar-site hernia

## FAQs

### Is laparoscopic better than open hernia repair?

For bilateral and recurrent inguinal hernias, NICE TA160 recommends laparoscopic repair as the preferred approach. For primary unilateral hernias, the choice depends on surgeon experience and patient preference; recurrence rates are comparable but chronic post-operative pain is lower with laparoscopic in experienced hands.

### What is the difference between TAPP and TEP?

TAPP (transabdominal preperitoneal) enters the abdominal cavity, then dissects the preperitoneal space from inside. TEP (totally extraperitoneal) dissects the preperitoneal space from outside without entering the peritoneum. Outcomes are broadly similar; the choice usually depends on surgeon training and preference.

### Can laparoscopic repair be done under local anaesthesia?

No — laparoscopic hernia repair requires general anaesthesia due to the need for muscle relaxation and pneumoperitoneum. Open repair can sometimes be done under local anaesthesia in selected patients.

### How long until I can fly home?

Most surgeons permit flying 3-5 days after uncomplicated laparoscopic repair. DVT prophylaxis per IATA medical guidance is recommended for long-haul flights.

### What is the recurrence rate?

In experienced hands, recurrence rates for laparoscopic primary inguinal hernia repair are 1-3%. Recurrence rates rise significantly with low-volume surgeons or complex cases. The Cochrane review of open vs laparoscopic mesh repair shows comparable overall recurrence rates between approaches in adequately powered studies.

### Will I have visible scars?

Three small port-site scars, each approximately 5-10mm long, typically placed in the umbilicus and the lower abdomen. These usually fade to near-invisibility within 6-12 months.

### Can I have laparoscopic repair if I have had previous abdominal surgery?

Previous abdominal surgery is not an absolute contraindication but may make laparoscopic dissection more difficult due to adhesions. The surgeon may convert to open repair intra-operatively if access is unsafe. Discuss your previous surgery in detail at the pre-operative consultation.

### Can I have laparoscopic hernia repair if I have had previous abdominal surgery?

Previous abdominal surgery is not an absolute contraindication, but extensive adhesions can make laparoscopic access more difficult. The TEP variant (totally extraperitoneal) is sometimes preferred over TAPP in this situation because it avoids entering the abdominal cavity. The surgeon may convert to open repair intra-operatively if safe laparoscopic access is not achievable.

### What is the difference between TAPP and TEP in clinical outcome?

TAPP and TEP have broadly comparable long-term outcomes (recurrence, chronic pain) in adequately powered trials. TAPP allows inspection of the contralateral side and the abdominal cavity, which can reveal occult hernias; TEP avoids peritoneal entry, reducing the rare risk of bowel injury. The choice usually depends on surgeon training and patient anatomy.

## Sources

- [Cochrane Database — Open versus laparoscopic mesh repair for primary unilateral inguinal hernia](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001785.pub2/full) — Cochrane Database of Systematic Reviews (accessed 2026-05-09)
- [RCoA — Guidelines for the Provision of Anaesthetic Services (GPAS)](https://www.rcoa.ac.uk/standards-of-clinical-practice) — Royal College of Anaesthetists (accessed 2026-05-09)
- [WHO Surgical Safety Checklist](https://www.who.int/teams/integrated-health-services/patient-safety/research/safe-surgery) — World Health Organization (accessed 2026-05-09)
- [NICE TA160 — Laparoscopic surgery for inguinal hernia repair](https://www.nice.org.uk/guidance/ta160) — National Institute for Health and Care Excellence (accessed 2026-05-09)