ObjectiveTo study the efficacy, the operation skills, and the complications of laparoscopic totally extraperitoneal prosthesis (TEP). MethodsThe clinical data of 1 020 patients received TEP from April 2011 to March 2014 were retrospectively analyzed. The oral feeding time, out of bet time, operation time, hospital stay, hospitalization costs, postoperative complications, and so on were recorded. ResultsAmong the 1 020 patients, the types of hernias were 810 indirect inguinal hernias (including unilateral hernia and bilateral hernia), 118 direct inguinal hernias, 24 femoral hernias, and 68 recurrent inguinal hernias. The surgeries were basically successfully completed in all the patients, including 12 cases (both recurrent hernia) of conversion to laparoscopic transabdominal preperitoneal prosthesis (TAPP). All the patients could take food in a day and get out of bed on day 1 after operation. The unilateral operation time was (48±9.8) min, bilateral was (65±8.6) min. The postoperative hospital stay was 0.5-2.0 d, total hospital stay was (3.48±2.40) d, hospitalization costs was (8 958±1 685) yuan. Main complication was 61 (5.98%) cases of seroma, 48 (4.70%) cases of temporary nerve paresthesia, 23 (2.78%) cases of urinary retention, 9 (0.88%) cases of chronic pain, and 5 (0.49%) cases of abdominal artery injury. No incision infection, visceral injury, small intestinal obstruction, and other serious complications happened. No occurrence occurred with following-up for 1 year. Classification of different hernia complications, the statistical analysis showed that the total incidence of complications of the typeⅣwas highest, then which was in sequence of typeⅢ, typeⅡ, typeⅠ(P < 0.001). ConclusionLaparoscopic TEP is a safe, reasonable repair without tension with small incision, lighter abdominal interference, less pain, early return to normal activities, but it is a difficult technology and has a higher cost.