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General Surgery · Hernia and abdominal wall: TEP versus TAPP
Sample itemBoth TEP and TAPP are laparoscopic mesh repairs for groin hernias. What is the principal feature of the TEP approach compared with TAPP?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. It works entirely in the preperitoneal space
In TEP the surgeon dissects the preperitoneal space with a balloon or blunt dissection and never enters the peritoneal cavity, which lowers the risk of visceral injury and adhesions. In TAPP the peritoneum is incised and later closed over the mesh.
Option by option
A. It works entirely in the preperitoneal space (correct)
Correct. TEP stays outside the peritoneal cavity throughout, working in the preperitoneal plane.
B. It is unsuitable for bilateral hernias
TEP is well suited to bilateral hernias because both sides are reached through the same space.
C. It needs an open Hasson entry into the abdomen
An open Hasson entry into the abdominal cavity is not required in TEP, which uses a preperitoneal entry.
D. It requires suturing of a peritoneal flap
A peritoneal flap closed over the mesh is a step of TAPP, not TEP.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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