This report describes a laparoscopic transabdominal preperitoneal herniorrhaphy of groin hernias using an abdominal wall-lifting method under regional anesthesia as compared with pneumoperitoneum under general anesthesia. The series of studies involved the repair of 20 groin hernias; 7 hernias were direct, 11 were indirect, and 2 were femoral. These included 7 recurrent, 1 incarcerated, and 4 bilateral hernias. There were no intraoperative complications, and both procedures required no conversion to open surgery. There are no significant differences between the two groups in operative time and postoperative hospital stay. The only postoperative complication of our procedure was temporary inguinal pain in 2 cases. The follow-up period ranged from 8 to 17 months. To date, no recurrence has developed. We conclude that our procedure is a safe, technically feasible, and useful method to perform laparoscopic herniorrhaphy for groin hernias.