Purpose: to compare laparoscopic two-port completely extraperitoneal (TEP) inguinal hernia repair to the traditional three-port method in order to assess the long-term results, safety, and feasibility of the procedure. Methods: A two-year prospective analysis was conducted at Theodor Bilharz Research Institute hospital between 2021 and 2023, comparing 35 patients who had two-port TEP to 35 patients who underwent traditional three-port TEP. Results: 33 patients underwent two-port TEP repairing 35 hernias, while 34 patients underwent 3 ports TEP repairing 35 hernias. 30 (85.7%) patients in group A
and 32 (91.4%) in group B were male. Mean age ± SD was 42 ± 15 years in group A vs.38 ± 19 years in group B. Mean body mass index ± SD was 38.0 ± 7.7 kg/m2 in group A vs.35.0 ± 8.1 kg/m2 in group B. Indications for surgery included primary repair 33 (94.2%) in group A vs.34 (97.1%) in group B, recurrence from open repair 1 (2.9 %) in each group, and incarcerated inguinal hernia 1 (2.9 %) in group A. 33 (94.4 %) cases in group A and 34 (97.1) cases in group B were unilateral. Operative time ± SD was 48.2 ± 19.9 min in group Avs.43.7 ± 17.9 min in group B for unilateral repair and 69.4 ± 31.6 min in group A vs. 65.2 ± 29.8 min in group B for bilateral repair. Two-port TEP was successful in 33 (94.2 %). single (2.9 %) case required the addition of a third port in group A. single (2.9 %) cases were converted to TAPP repair in group A. Mean follow-up time ± SD was 9.4 ± 3.7 months. Postoperative
complications included seroma 2 (5.7%) cases in group A and 1 (2.9 %) case in group B, hematoma 1 (2.9 %) in group A, chronic inguinal pain 2 (5.7%) cases in group A and 1 (2.9 %) case in group B. single (2.9 %) hernia recurred in group A. Conclusion: With applying big 3DMaxTM Mesh, two-port TEP
appears to be a practical, safe, and effective procedure for laparoscopic inguinal hernia repair. It should be regarded as a viable, less invasive alternative to traditional three-port techniques.