In laparoscopic totally extraperitoneal (TEP) inguinal hernia repair, the key plane of dissection to create the preperitoneal space lies between:

• A Anterior rectus sheath and rectus abdominis muscle
• B Rectus abdominis posteriorly and the posterior rectus sheath/transversalis fascia anteriorly
• C External oblique aponeurosis and internal oblique
• D Transversalis fascia and parietal peritoneum (preperitoneal space of Retzius/Bogros) ✓

Explanation

In TEP repair, the surgical dissection plane is the preperitoneal space (space of Retzius medially and space of Bogros laterally), located between the transversalis fascia anteriorly and the parietal peritoneum posteriorly. Entry is made posterior to the posterior rectus sheath through a sub-umbilical incision. Staying anterior to the peritoneum avoids peritoneal entry and maintains the extraperitoneal working space essential for mesh deployment over the myopectineal orifice.

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.