Traditional inguinal hernia repair surgery has undergone more than a century of evolution and has increasingly revealed its shortcomings. In addition to having more complications, its high recurrence rate of 10%-20% is more difficult to resolve. Since Lichtenstein first proposed the concept of tension-free hernia repair in 1986 after years of practice, more than 80% of inguinal hernias in Western countries are now treated with tension-free repair, with a recurrence rate of about 1%. With the continuous development of anatomy, the modern anatomical theory of the inguinal region has become the cornerstone of hernia surgical repair surgery. Weak structures in the inguinal region and defects in the transverse abdominal fascia are considered to be the underlying cause of hernia development. A common drawback of various traditional hernia repairs is the problem of tension at the repair site. Tension suturing of tendons and ligaments, which are in normal position but not the same tissue, not only causes postoperative discomfort to the patient, but can also lead to local tissue tearing, creating a new defect and creating conditions for hernia recurrence. Common causes of hernia recurrence after tension-free mesh repair Surgical causes: recurrence due to improper surgical operation; oversized hernia ring opening and too small mesh plug; improper fixation of the mesh plug and its postoperative prolapse with the hernia sac; intraoperative displacement of the mesh plug caused by the hernia sac not being freed to a high position; the mesh not being circumferentially fixed to the internal hernia ring hole during surgery; postoperative recurrence due to improper placement or poor fixation of the mesh resulting in displacement; the dovetail end of the mesh being placed on the superficial surface of the joint tendon. Inadequate contact between the mesh and the transverse abdominal fascia; Lichtenstein’s pre-cut mesh hole was too large at the time of surgery; the mesh was too small to block all abdominal wall weaknesses; missed transverse hernia or compound hernia, and only a single hernia was treated intraoperatively. Non-surgical factors leading to physical defects, such as poorly developed or degenerated tendons and muscles, and excessive obesity. Inappropriate preoperative and postoperative management, such as untreated cough, constipation, or difficulty in urination, as well as early postoperative activity or excessive weight bearing. Inguinal hernia surgery is a minor surgery, which large physicians do not want to do and small physicians cannot do well. Therefore, it is especially important to strengthen the training of hernia specialists in primary care hospitals and to adopt “individualized” treatment plans for each patient to prevent recurrence after inguinal hernia surgery.