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ONSTEP is an open preperitoneal approach for inguinal hernia repair. The technique is simple, fast and consists of twelve standardized steps. The video provides a full step-by-step description of the technique, with some tips and tricks included. The case refers to a 35-year-old man with a right-sided primary inguinal hernia. The procedure took around 15 minutes, was uneventful, and no clinically significant postoperative pain was noted. The patient was able to return to work within 2 weeks. After two years of follow-up, the patient remains pain–free and without recurrence. The ONSTEP technique is an excellent option for inguinal hernia repair, especially for primary unilateral hernias in male patients. The authors believe that this approach should be part of the hernia surgeon´s therapeutic armamentarium.

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