The authors will present a new version of preperitoneal hernia repair performed with laparoscopic techniques. Pertinent anatomy as viewed from the peritoneal side of the defect, and the method of dissection will be reviewed. The technique involves placing polypropylene mesh bolsters into the defect and surfacing the peritoneal side of the musculofacial defect with a sheet of mesh. A review of an approximate 16-month clinical trial points out the advantages of the procedure, noting specifically that the patients have been able to return to unrestricted activity within four days of surgery.