Total laparoscopic extraperitoneal (TEP) hernia repair has the advantages of minimally invasive procedures as compared to open conventional surgery. However, surgeons have been reluctant to adopt this procedure because it requires commonly general anesthesia. In this report, we describe a laparoscopic TEP approach, under local anesthesia, to repair an inguinal hernia in a 77-year-old man who was not indicated to receive general anesthesia and/or epidural anesthesia because of cardiac problems, hypertension and a history of cerebral infarction with hemiparesis. We used lidocaine and midazolam as sedatives. The operative time was 105 min. He was discharged on the first postoperative day uneventfully and has been doing well on follow up with no recurrence.

Keywords: Laparoscopy, Hernia, Anesthetics, Local