The purpose of this study was to compare between laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair of inguinal hernia in recurrent inguinal hernia.

The primary objective in this study was to compare postoperative pain between the TAPP group and the TEP group. The secondary objective was to compare operative time, intraoperative complications (bleeding, bowel injury, vascular injury), postoperative complications (hematoma, seroma, wound infection), length of hospital stay and recurrence rate with possible risk factors which include gender, age, BMI ,cord lipomas and location of the hernia.

Inclusion Criteria:

• Patients diagnosed with unilateral or bilateral recurrent inguinal hernias.
• Patients between 18 and 70 years old
• Fit for anesthesia.
• Agree to participate in the study
• Both genders were included.

Exclusion Criteria:

• Unfitness for general anesthesia and operation.
• Age < 18 years or >70 years.
• Complicated hernias (acute irreducible, obstruction or strangulation).
• The presence of mental or psychological disorders.
• Refusal to participate in the study.

Each patient was randomly allocated to the TAPP group or the TEP group by sequentially numbered, opaque , sealed envelope (SNOSE) technique on the day of surgery. An independent statistician , who was not involved in patient care, generated the randomization sequence via a computer generated random number. The randomization code was contained in opaque sealed envelopes. A junior resident , who opened the envelope , was not actively involved in outcome measurements .Before randomization and during the consent, all patients received an explanation of the objectives of the study, techniques and complications associated with both procedures.