The TAPP (Transabdominal Preperitoneal) repair and TEP (Totally Extraperitoneal) repair are laparoscopic approaches to inguinal hernia. Which of the following best distinguishes TEP from TAPP?

• A TEP uses a larger mesh than TAPP
• B TAPP cannot be used for bilateral hernias
• C In TEP, the peritoneal cavity is not entered, whereas in TAPP the peritoneum is incised ✓
• D TEP requires general anesthesia while TAPP can be done under spinal anesthesia

Explanation

The fundamental distinction between TEP and TAPP is the relationship to the peritoneal cavity. In TEP, the entire dissection is performed in the preperitoneal space without ever entering the peritoneal cavity, providing direct access to the myopectineal orifice. In TAPP, the peritoneal cavity is entered laparoscopically, the peritoneum overlying the inguinal region is incised, the preperitoneal space is developed, mesh is placed, and the peritoneum is re-closed. Both approaches can manage bilateral hernias and use similar mesh sizes; the main advantage of TEP is avoidance of intraperitoneal entry and its associated risks.

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.