In hernia surgery you must perform the repair that you master THE BEST. In the opinion of specialists, you may begin with TAPP.

TEP is a tricky procedure, it needs longer learning curve than the TAPP.

In the beginning of my career I was told that I should start to learn and master TEP 1st, then shift to TAPP. This advice was a blessing, surgeons who started their pathway with TAPP find it very difficult to accept TEP.

There is no formal o high-quality recommendation for such a decision.

We use TAPP with low pneumoperitoneum pressure (8 mm Hg) and subdural single-dose for patients with hernia defects with 40 millimeters diameter and tomographic confirmation of bowel or bladder compromise and bilateral hernia defects.

TEP approach is reserved for a small hernia defect in a young and active working patient. This decision is because we are in an institutional high-specialty health unit that only provides health services to the PEMEX workforce.

In our private practice decision regrettably goes hand in hand with the patient's economic possibilities.

Fortunately, outcomes are statistically similar and we are working on publishing such results.

TEP is better for unilateral hernia with previous abdominal surgery meanwhile TAPP is preferable for bilateral hernia but surgeons should be proficient in both techniques.

'The choice of the technique should be based on the surgeon's skills, education and experience"

HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018 Feb;22(1):1-165. doi: 10.1007/s10029-017-1668-x. Epub 2018 Jan 12. PMID: 29330835; PMCID: PMC5809582.