Inclusion Criteria:  Patients older than 18 years of age and able to understand and give their informed consent for the study. Primary unilateral or bilateral hernia  Exclusion Criteria:  Recurrent hernia with previous open abdominal surgery at or below the umbilicus need of an open inguinal hernia repair (patient's preference, unable to undergo general anesthesia, unable to tolerate pneumoperitoneum) liver disease defined by the presence of ascites end-stage renal disease requiring dialysis unable to give informed consent need of an emergency surgery pregnancy