Inguinal hernia repairs are one of the most performed general surgery operations worldwide (Kingsnorth A, LeBlanc K. Lancet 362:1561–1571, 2003). With the widespread adoption of the Lichtenstein tension-free hernioplasty method, recurrence rates have fallen to under 1–3% (Naveen N, Srinath R. J Clin Diagn Res 8:88–91, 2014; Manyilirah W, Kijjambu S, Upoki A, Kiryabwire J. Hernia 16:133–144, 2012). The principles of open mesh-based inguinal hernia repair rely on the reconstruction and reinforcement of the inguinal floor with a flat prosthetic mesh rather than on joining weakened tissue under excess tension as is performed with tissue-based repairs. The Lichtenstein repair places a flat mesh to cover the inguinal ring laterally and extends beyond the pubic tubercle. Care must be taken to identify and protect the inguinal nerves to minimize the risks of chronic postoperative inguinal pain.