Hernia is a common and frequent disease in surgery, commonly known as “hernia” and small intestine gas. After suffering from a hernia, people often adopt negative attitudes such as “not recognizing it as a disease”, local compression, delaying tactics, etc. They are not willing to go to the hospital until their daily activities such as walking are affected or serious complications such as pain and impaction occur. Some elderly patients have been suffering from hernia for decades and eventually want to undergo surgery, but because of systemic cardiopulmonary and renal insufficiency, they cannot undergo surgery and regret for the rest of their lives. The traditional tissue-to-tissue suture method has been used for hundreds of years and is still used in some regions. However, with the development and progress of medicine, tension-free repair surgery using patches has become the mainstream method worldwide. Especially in recent decades, surgeons and hernia patients around the world have reached an unprecedented level of concern about hernias, due to the rapid development of medical technology itself which has brought about technological innovation, while high-quality medical services are increasingly valued and needed by the majority of patients. Currently there are many different surgical options for the treatment of inguinal hernia in China, but the overall choice is between two main categories, open surgery and minimally invasive-laparoscopic surgery. These two types of procedures have their own advantages and disadvantages, and their application should be individualized to achieve the best results for the patient. Open tension-free hernia repair 1. Open tension-free hernia repair was introduced to China from abroad in 1997 and then rapidly spread throughout the country. One of the greatest advantages of this tension-free hernia repair is the low recurrence rate, which has been below 2% in China. In addition to this, the surgery can be done under local anesthesia. It usually requires only 2-5 days of hospitalization, and the procedure can even be completed on an outpatient basis. The open tension-free hernia repair methods commonly used in China are summarized as follows:1 Flat-piece tension-free repair method (Lichtenstein procedure): Lichtenstein procedure involves suturing the patch to the wall of the inguinal canal and the spermatic cord is led out through the patch by perforation. Before 1997, it was recognized worldwide as the most classic procedure for hernia surgery. There are still many hospitals in China that still perform this surgery. 2. Tension-free repair with hernia ring filling (Gilbert, mesh plug & patch): This procedure combines mesh plug filling (mesh plug, 1994) and Lichtenstein’s operation, that is, filling the hernia ring defect with polypropylene rolled into an umbrella shape, then strengthening the posterior wall of the inguinal canal with a flat patch, and once the umbrella filling and the flat patch were not fixed. Later on, Rutkow and Robbines suggested to fix the umbrella filling and the flat sheet separately, and the finalized product was produced by Bard Company in the United States, which is a popular hernia repair procedure abroad and the most rapidly developing procedure in recent years. 3.Prolene 3 in 1 —- tension-free hernia repair method (prolene hernia system, PHS) This procedure applies the stereotyped product (PHS) produced by Johnson & Johnson in the United States, which consists of three parts: an underlying piece placed in front of the peritoneum to repair the pubococcygeal muscle hole; a plug-like intermediate to repair the hernia ring; and a superficial piece to repair the posterior wall of the inguinal canal. This is a method introduced in recent years, and there are many hospitals in China performing this kind of surgery. 4, anterior peritoneal space lining patch tension-free hernia repair method (Kugel): This is a new tension-free hernia repair method proposed in 2000, applying the memory memory elastic ring patch (Kugel patch) produced by Bard Company in the United States to repair the pubococcygeal muscle hole by placing it in the anterior peritoneal space. With the rapid development of synthetic material science, the patch material has reached the ideal requirement for the overall repair of the three potential defects of the internal ring, direct hernia triangle and femoral ring, which is the concept of total inguinal repair. Currently, the open procedure in our department for inguinal hernia treatment is mostly anterior peritoneal space patch placement repair under local anesthesia, which is performed under local anesthesia and the patch is placed in the anterior peritoneal space with satisfactory results. Minimally invasive-laparascopic repair of inginal hernia: In 1982, Ger first performed laparoscopic inguinal hernia repair with success, and clinical reports of this technique have gradually increased and diversified repair methods have emerged, bringing a new technique and showing a broad prospect for inguinal hernia repair. Laparoscopic hernia repair is a minimally invasive technique developed on the basis of the joint development of lumpectomy and tension-free hernia repair, and is another successful procedure after the minimally invasive surgery of lumpectomy for biliary, colonic and gastric diseases. The advantages of this method are as follows: minimally invasive, no large incisions, and freedom of movement from the ground after surgery. It is possible to solve the problem bilaterally in a single operation, and the exploration of the hernia prevents the risk of missed hernia and eliminates the risk of incision. The risk of infection is minimal. Tension-free hernia repair techniques use patches, and postoperative infection is the most feared, but infection is extremely rare with minimally invasive techniques. Low recurrence, as surgeons with extensive experience in laparoscopic surgery can further reduce recurrence rates to 0.1%. Early return to work, especially for active workers who need to return to work or elderly people who like to exercise should prefer this procedure. In addition, laparoscopic total extraperitoneal repair is most appropriate for bilateral inguinal hernias and recurrent hernias. Because of the advantages of less trauma, faster recovery and lower recurrence, and the diminishing gap between the cost of treatment and that of open artificial mesh repair, this procedure has become more and more acceptable to patients, but total extraperitoneal hernia repair is technically challenging and requires a surgeon with extensive experience in laparoscopic surgery to perform this procedure. Rational choice of procedure Both open and lumpectomy are currently internationally recognized treatment options. The open procedure is simple and quick, and local anesthesia expands the indications for surgery and is an affordable option. The laparoscopic procedure is minimally invasive, without large incisions and with little trauma. General anesthesia allows patients to have no intraoperative discomfort, with less postoperative pain and shorter return to work, and is currently the most advanced concept for radical inguinal hernia treatment. The choice of minimally invasive laparoscopic surgery requires a surgeon with good specialized training to perform it so as to ensure the efficacy. Whether a patient with inguinal hernia is suitable for laparoscopic or open surgery, the surgeon should fully inform the patient of the respective risks and advantages of open and laparoscopic surgery and should be part of the surgical consent form, and the patient should make the choice based on his or her own situation and professional advice.