Laparoscopic herniorrhaphy is a new and presently evolving technique a
pplied to the repair of inguinal defects. Many different authors have
described various methods by which this can be achieved. Some of these
include the transabdominal preperitoneal approach, the plug technique
, the intraperitoneal onlay of mesh, and the extraperitoneal approach.
The authors have performed 252 laparoscopic hernia repairs utilizing
a form of the transabdominal preperitoneal procedure that is referred
to as the ''transperitoneal anatomic approach.'' The development of ne
w procedures or the modification of existing procedures can create new
problems or alter the pattern of traditional complications. These pro
blems must be thoroughly evaluated and reported if repetition of these
errors is to be avoided. Five cases of meralgia paresthetica are repo
rted that resulted from staple entrapment of the lateral femoral cutan
eous nerve during laparoscopic herniorrhaphy. An understanding of the
preperitoneal inguinal anatomy and precise placement of staples will a
llow avoidance of this complication.