In a comparative trial of 491 consecutive herniorraphies by Kald et al12, TAPP was compared with TEP. Hernia recurrence was shown to be higher in the TAPP group (7/339 vs 0/87) after a mean follow up of 23(9) and 7(4) months respectively. Other complications were similar with both the techniques (table). However, serious intraabdominal complications occurred in the TAPP group - 2 patients with bowel obstruction and one with severe neuralgion. These complications were not seen with a completely preperitoneal TEP approach. Although the TEP method is technically more difficult, the mean operative time in TAPP (339 patients) and TEP (87 patients) groups were similar {80(32) minutes vs 80 (41) minutes; p = 0.9}. The mean hospital stay and the times to full recovery were also similar in the TAPP and TEP groups. The authors concluded that high quality hernia surgery can be performed with both the TAPP and TEP techniques, but the potential danger of transabdominal route suggests that the TEP operation may be the procedure of choice in laparoscopic inguinal hernia repair.