Recently, a patient with bilateral inguinal hernia, male, 68 years old, was admitted to the Department of Surgery of the Chinese Hospital. He was admitted to the hospital with a repeatable mass in the bilateral inguinal region for more than 4 months. The patient presented with bilateral inguinal masses with no obvious cause 4 months ago. The masses protruded when standing, coughing and walking, and disappeared when lying down. The right side could enter the scrotum, while the left side did not enter the scrotum. Physical examination: clear, 4×3 cm pear-shaped mass in the right inguinal region, 3×2 cm hemispherical mass in the left. Both were retractable and the transillumination test (-). After retraction, pressure was applied to the inner ring opening, and then coughing, no mass protruded on the right side, but the mass still protruded on the left side. Admission diagnosis: right inguinal hernia and left inguinal hernia. Considering the patient’s old age, a conventional hernia repair would require a 6-8 cm incision in each inguinal region bilaterally, which would be more traumatic; and there was no laparoscopic equipment in the Chinese hospital in Guilao, so laparoscopic hernia repair could not be performed. The doctors cooperated and used posterior approach preperitoneal repair under epidural anesthesia to treat bilateral inguinal hernia, i.e. open TEP surgery. Only a small incision of 5-6 cm was made in the middle of the lower abdomen, through which the space for the mesh was carefully separated into the bilateral preperitoneum, and then two 8*15 cm polypropylene patches were placed into the patient’s preperitoneal space. The whole procedure took less than 2 hours, and 6 hours after the operation, the patient was able to eat and get out of bed, urinate spontaneously, and had mild wound pain and no postoperative discomfort such as fever. The patient felt quite satisfied and was about to be discharged from the hospital. According to the doctor, complete extraperitoneal inguinal hernia repair (TEP) was originally one of the standard procedures for laparoscopic hernia repair, and was later clinically derived as open TEP surgery. This procedure is performed under direct vision by making a small incision in the middle of the lower abdomen, freeing the preperitoneal space, dealing with the hernia sac, walled spermatic cord, and placing the patch in the preperitoneum, strengthening the innermost layer of the entire abdominal wall defect, making the repair more reasonable and secure, comprehensively covering the weak areas such as the internal ring, femoral ring and direct hernia triangle, and avoiding the nerves in the surgical area, resulting in less postoperative pain, while not requiring sutures to fix the patch and making the operation more convenient. It is also easier and more convenient. Open TEP surgery has a wide range of indications, especially for patients with bilateral inguinal hernia, or one inguinal hernia, contralateral occult hernia or suspected inguinal hernia. At the same time, the operation time is short, the trauma to the patient is small, the recovery is fast, and the cosmetic effect is better, which makes it more acceptable to the majority of patients compared to the traditional surgical approach.