Totally endoscopic inguinal hernia repair: A new approach

•New minimally invasive approach for combined defects of the abdominal wall.•Endoscopic approach for one side inguinal hernia and midline abdominal wall defect.•First successful experience with no recurrence in first six months.•Same advantages of minimally invasive approach in the new technique.•More experience is required in a high laparoscopic volume center. Minimally invasive approach is used to repair as many defects of the abdominal wall as possible with the same approach, with the advantages implied by this way to perform surgery. Nowadays, efforts are made to create a minimally invasive approach to cope with the necessity to repair different defects of the abdominal wall at the same time. A minimally invasive approach, with long standing endoscopic and laparoscopic principles on a well stablished inguinal hernia repair technique (Lichtenstein), is used to create a new approach to restore a unilateral inguinal hernia with the possibility to perform an adjunctive approach to solve other defects of the abdominal wall, in this case midline incisional hernia. A written consent was previously obtained, and Institutional Review Board approval was not needed. We performed an endoscopic repair of a right inguinal hernia, and a laparoscopic approach using the same surgical site to repair a midline incisional hernia. Patient was discharged at 36 hs post-procedure. Sixth month later the patient does not have evidence of a recurrence of either defect. This new approach has proved to be feasible, giving the advantages of a minimally invasive approach, but more experience and time are needed before getting objective and real conclusions.