A 35-year-old man undergoes laparoscopic TEP (total extraperitoneal) inguinal hernia repair. Which complication is most specifically associated with TEP repair and not typically encountered in the open Lichtenstein repair?

• A Inguinal nerve damage causing chronic groin pain
• B Mesh infection
• C Recurrence of hernia within 5 years
• D Peritoneal tear causing pneumoperitoneum during the extraperitoneal dissection ✓

Explanation

In TEP repair, the entire operation is performed in the preperitoneal space. A peritoneal tear during dissection allows CO2 to escape into the peritoneal cavity, creating pneumoperitoneum that collapses the working space and may necessitate conversion to TAPP or open repair. This complication is unique to the TEP approach. Inguinal nerve damage and chronic groin pain occur in open repairs (ilioinguinal, iliohypogastric, genitofemoral nerves at risk). Mesh infection and recurrence can occur with any approach but are not specific to TEP.

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.