Vascular injury by tacks during totally extraperitoneal endoscopic inguinal hernioplasty.

Totally extraperitoneal laparoscopic hernioplasty is a consolidated approach for treating recurrent and bilateral inguinal hernias. However, it may be associated, albeit very rarely, with vascular lesions that can endanger the patient's life. A proper anatomic knowledge of the posterior aspect of the inguinal region and a perfect command of the laparoscopic technique are essential for avoiding and, if necessary, treating these lesions.