The value of the minimal invasive approach for treating groin hernias is not yet well defined. The standard treatment for primary hernia repair in Europe is an open approach (i.e. Shouldice) without mesh implantation. A mesh may be used to repair a so-called complicated hernia with a complete myopectineal defect, as well as for recurrent and bilateral hernias. These hernias can well be treated laparoscopically despite the fact that the approach is difficult and that there is an increase of direct costs. Whether or not a transabdominal (TAPP) or preperitoneal (TEP) endoscopic approach is used depends on the type of hernia, the risk to the patient, and the surgeon's experience. Morbidity and long-term follow-up are identical for both techniques (TAPP and TEP). The advantages for TAPP repair are that the technique is simpler, with a large working space and good diagnostic tools.