TAPP vs. TEP vs. rTAPP: What Does the Evidence Show?

Laparoscopic surgery for repair of inguinal hernias with mesh has been used for over 25 years, since it was first described in 1991 by Shultz. The aim of this chapter is to look at the current data and evidence available comparing the TEP and TAPP techniques for inguinal hernia repair with mesh, as well as a comparison of the laparoscopic repairs to the rTAPP. While there are several studies, including randomized controlled trials and meta-analyses, comparing open and laparoscopic inguinal hernia repairs, there is less data directly comparing the two laparoscopic techniques. There are even fewer studies comparing laparoscopy to the newer rTAPP. In addition to landmark papers, the most current published data will be discussed in this chapter to see what evidence is available to help choose the right minimally invasive technique for both the surgeon and patient.