In laparoscopic inguinal hernia repair (TAPP — transabdominal preperitoneal), the anatomical space dissected and where the mesh is placed is:

• A Between the external and internal oblique muscles
• B Deep to the transversalis fascia, intra-abdominally
• C Within the inguinal canal between the spermatic cord and the internal oblique
• D Between the peritoneum and the transversalis fascia (preperitoneal space of Bogros/Retzius) ✓

Explanation

In TAPP (transabdominal preperitoneal) repair, a transabdominal approach is used: the peritoneum is incised to enter the preperitoneal space (space of Bogros laterally, Retzius medially), the hernia defect(s) are identified and reduced, a large polypropylene mesh is placed in the preperitoneal space covering the myopectineal orifice (direct, indirect, and femoral spaces), and the peritoneum is closed over the mesh. In TEP (totally extraperitoneal), the peritoneal cavity is never entered. Both place mesh in the preperitoneal space. The Lichtenstein places mesh anterior to the transversalis fascia in the inguinal canal.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.