Abstract
Background: Enhanced view totally extra peritoneal (eTEP) approach for inguinal and ventral hernias repair is becoming the preferred technique. Initially the technique was described by Jorge Daes for inguinal hernia repair and later Igor Belyansky applied this technique for ventral and incisional hernia repair. Since it does not penetrate the peritoneal cavity, the major advantage of this approach is in reducing the risk of intestinal and vascular injuries as well as herniation at the trocar sites. This eTEP approach provides scope for flexible port placement and wide coverage by the prosthetic mesh in the retromuscular space with hardly any transfascial fixation. Here we bring forward the technical benefits and avoidable hurdles encountered which might render this as most sought approach.
Patients and Methods: 72 patients with mean age of 44 yrs underwent eTEP repair between July 2018 and June 2022. The data was analysed for standardising the surgical steps of eTEP approach, operative time taken, technical advantages in this approach and hurdles encountered
Results: All 72 patients underwent laparoscopic repair successfully. There were six conversions to alternate laparoscopic hernia repair techniques. The operative time improved with the subsequent surgeries though initially it was prolonged.
Conclusion: Our clinical experience with eTEP approach has been convincing. With improved technical steps, adjunct hybrid manoeuvres & hurdles overcome; eTEP is becoming a favourable approach for laparoscopic inguinal and ventral hernias repair in our practice. We believe this technique makes a striking presence among all the types of surgical approaches for laparoscopic hernia repair.

Key words: eTEP, Laparoscopic inguinal hernia repair, Laparoscopic ventral hernia repair