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Introduction: Peritoneal tear (PT) is a common surgical challenge in laparoscopic totally extraperitoneal (TEP) hernioplasty and the most common reason for conversion surgery. It prolongs the operation time and may cause serious complications. Therefore, rapid closure of PTs is essential. Methods: This is a retrospective study of patients with PTs during TEP hernioplasty and PT closure using the extracorporeal peritoneal knotting (ECPK) technique. Patient demographics, operative findings, and the success of the technique were evaluated. Results: The technique was successful in eight of the 10 patients. In two patients with a high body mass index (MRI), the technique failed, so an additional closure technique was required. No complications occurred, and conversion surgery was not required. Conclusion: ECPK is an easy technique and does not require wide surgical experience and additional laparoscopic surgical devices. The success rate is high in patients with low MRI and may reduce the operation time compared with other peritoneal closure techniques. [ABSTRACT FROM AUTHOR]