BACKGROUND Although laparoscopic inguinal hernia repair was described about 30 years ago and advantages of the technique have been demonstrated, the utilization of this approach has not been what we would expect. Some reasons may be the need for surgeons to understand the posterior anatomy of the groin from a new vantage point, as well as to acquire advanced laparoscopic skills. Recently, however, the introduction of a robotic approach has dramatically increased the adoption of minimally invasive techniques for inguinal hernia repair. METHODS Important recent contributions to this evolution have been the establishment of a new concept known as the critical view of the Myopectineal Orifice (MPO) and the description of a new way of understanding the posterior view of the antomy of the groin (inverted Y and the five triangles). In this paper, we describe 10 rules for a safe MIS inguinal hernia repair (TAPP, TEP, ETEP, RTAPP) that combines these two new concepts in a unique way. CONCLUSIONS As the critical view of safety has made laparoscopic cholecystectomy safer, we feel that following our ten rules based on understanding the anatomy of the posterior groin as defined by zones and essential triangles and the technical steps to achieve the critical view of the MPO will foster the goal of safe MIS hernia repair, no matter which minimally invasive technique is employed.

中文翻译：

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以新的解剖学概念为指导进行安全 MIS 腹股沟疝修补术的 10 条黄金法则。

背景尽管腹腔镜腹股沟疝修补术大约在 30 年前被描述并且已经证明了该技术的优势，但这种方法的使用并不是我们所期望的。一些原因可能是外科医生需要从新的有利位置了解腹股沟的后部解剖结构，以及获得先进的腹腔镜技术。然而，最近，机器人方法的引入极大地增加了微创技术在腹股沟疝修复中的采用。方法 最近对这一演变的重要贡献是建立了一个新概念，称为肌耻骨孔 (MPO) 的批判性视图，并描述了一种理解腹股沟解剖后视图的新方法（倒 Y 和五个三角形）。在本文中，我们描述了安全 MIS 腹股沟疝修补术（TAPP、TEP、ETEP、RTAPP）的 10 条规则，它们以独特的方式结合了这两个新概念。结无论采用哪种微创技术，安全 MIS 疝修复的目标。