The main difference is the way the surgeon reaches this space.
- TAPP
- The abdominal cavity is entered and the peritoneum is then opened.
- TEP
- The preperitoneal space is reached directly, without entering the abdominal cavity.
Indications
- Inguinal hernia
- Femoral hernia
- Bilateral hernias
- Recurrent hernias
small skin incisions
How the TAPP procedure is performed
TAPP begins by accessing the peritoneal cavity…
- IFirst step
Through small laparoscopic access sites the abdominal cavity is entered and the inguinal region explored. This allows both inguinal regions to be seen directly and can reveal: bilateral hernias, associated femoral hernias and other defects not clinically evident.
- IISecond step
The hernia sac is reduced and the preperitoneal space is prepared. A large mesh is then placed, covering the myopectineal region and the main sites where a hernia may develop.
Large mesh covering all inguinal openings. - IIIThird step
The peritoneum is closed over the mesh. This keeps the mesh separate from the bowel loops.
How TEP is performed
TEP — Totally Extraperitoneal repair uses the same preperitoneal reinforcement principle but without entering the abdominal cavity.
The surgeon develops the space between the wall and the peritoneum directly and works entirely in this plane.
The difference is not where the mesh is placed: it is the route taken to get there.
In TEP too, the mesh is placed in the preperitoneal position and widely covers the inguinal openings.
Laparoscopy or robotics
Both techniques can be performed with a traditional minimally invasive or a robotic approach:
The anatomical principle remains the same.
The robotic platform can make some dissection and suturing steps easier, especially in selected or more complex cases, but it does not automatically make the procedure better for everyone.
Learn moreRobotic abdominal wall surgeryTiming and hospital stay
- About 1h30
Duration of surgery
- Discharge
As a day case or after one night
Timing can of course vary depending on the type of hernia and the complexity of the procedure.
Post-operative recovery
immediate
- Straight awayImmediate return to daily activities
- ≈ 20 daysReturn to sport
Frequently asked questions
What is the main difference between TAPP and TEP?
TAPP reaches the preperitoneal plane by passing through the abdominal cavity; TEP reaches the same plane directly without entering the peritoneal cavity.
Is the mesh in contact with the bowel?
No. In both techniques the mesh is placed in the preperitoneal plane. In TAPP the peritoneum is closed over the mesh.
Can TAPP and TEP be used for femoral hernia?
Yes. Both can be used in the minimally invasive treatment of inguinal and femoral hernias.
Can they be performed robotically?
Yes. The robotic variants are known as r-TAPP and r-TEP.
How long is the hospital stay?
Patients can generally be discharged the same day or after one night, depending on the clinical case.
The same hernia can be treated through different planes
TAPP and TEP both use the preperitoneal plane, but reach it by two different routes. The choice is made after assessing the type of hernia, anatomy, previous surgery and the patient's characteristics.