Femoral hernia repair, TIPP technique

The principle of transinguinal preperitoneal mesh repair (TIPP) involves the closure of the femoral hernia orifice with a synthetic mesh introduced via an open inguinal, thus anterior, approach between the parietal peritoneum and the transversalis fascia.

For this, the transversalis fascia must be opened, which is then closed either by a Shouldice suture or by simple suture.

After local anesthesia, a transverse skin incision approximately 4 cm long is made 1 fingerbreadth above the inguinal ligament. The subcutaneous tissue is divided, and the external oblique aponeurosis is exposed.

The inguinal canal is opened by incising the external aponeurosis starting from the external inguinal ring. The fascial edges are clamped, elevated, and separated from the internal oblique muscle. The round ligament of the uterus is prepared and slung.