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The mean operating time in minutes (SD) was significantly shorter in the TREPP group compared with the two other patient groups (TREPP 22.2 (± 5.7); TEP 38.7 (± 14.8); Lichtenstein 49.3 (± 17.1), P 0.001). No major complications occurred in any patient of the study groups. TREPP seems to be an effective and safe technique for unilateral primary inguinal hernia repair. It is found to be comparable to TEP and Lichtenstein in terms of recurrence rates, chronic post-operative inguinal pain, and clinically significant adverse events. Th