Conclusion  For surgeons performing the Lichtenstein repair but looking for modifications concerning pain relief and a quicker procedure, the TIPP approach is a feasible alternative that seems to be associated with less post-operative pain. Content Type Journal ArticleCategory Original articleDOI 10.1007/s00423-009-0544-2Authors Frederik Berrevoet, Ghent University Hospital and Medical School Department of General and Hepatobiliary Surgery and Liver Transplantation Service De Pintelaan 185, 2 K 12 IC 9000 Gent BelgiumLeander Maes, Ghent University Hospital and Medical School Department of General and Hepatobiliary Surgery and Liver Transplantation Service De Pintelaan 185, 2 K 12 IC 9000 Gent BelgiumKoen Reyntjens, Ghent University Hospital and Medical School Department...