Summary and ConclusionInguinal hernia repair is the frequently performed operation in general surgery. There has been a great upsurge in interest in hernias over at least 15 – 20 years sparked by the introduction and wide spread use of prosthetic mesh.In this study we evaluate the inguinal hernia repair by use lateral preperitoneal approach of Nyhus and Stoppa’s technique with placement of 12 x 10 cm M-shape polypropylen mesh.This study included fifty patients admitted to Zagazig University hospital, department of surgery and general Zagazig hospital, complaining of inguinoscrotal hernia, the patients were examined properly and systematically. Some investigation were done such as kideney function testes, liver function testes, fasting blood sugar, plain x-ray chest, abdominal ultra sonography and I.V.U in suspected cases. The patients were subjected to M-shaped preperitoneal hernioplasty using Nyhus and stoppa’s technique. The patients were followed up for at least 1 year and clinically examined at 1–12 month to determine early and later postoperative complication including ecchymosis, hamatoma, wound infection and recurrence.In our evaluation we can say that M-shaped preperitoneal hernioplasty (M.P.H) was indicated in all types of inguinoscrotal hernia either primary type or recurrent or multirecurrent also M.P.H. was indicated in femoral hernia.We believe that M-shaped preperitoneal hernioplasty (M.P.H) provides important saving in surgical material costs when compared with other classical and preperitoneal procedures. In our openion at least 50% decrease in suture costs with respect to the Lichtenstien operation can be accomplished because only one no. 1 polypropylene suture is used for the whole M-shaped preperitoneal hernioplasty.M-shaped preperitoneal hernioplasty is a single safe and easy repair for inguinoscrotal hernias regard less of the type of hernia or the concomitant clinicopathological features of the patient.. The preperitoneal approach affords direct observation of the entire groin area making all defects readily identifiable.analysis, proctosigmoidoscopy, rectal snip examination and biopsy forhistopathological staining with Hematoxylin and Eosin and IHC staining fordetection ofBcl-2 oncogen expression.