The patient was from Heilongjiang, with a history of inguinal hernia for several years, and had been treated locally with sclerotherapy ten times. Now the hernia had not healed and several hard nodes had been added subcutaneously in the inguinal region, causing unbearable pain. During anesthesia, several hard nodules could be detected at the external ring opening, and the skin was incised subcutaneously layer by layer to the extra-abdominal oblique tendon membrane, the inguinal canal was opened, and the levator muscle was incised, and the spermatic cord was found to be tightly adhered by sclerosing agent at the external ring opening, making it difficult to lift it free. The hernia sac was located within the internal fascia of the spermatic cord, which was a hiatal hernia, and the contents of the hernia were the greater omentum. The hernia sac was opened, the contents of the hernia were returned and the hernia sac was transected, the proximal end was sutured, and the distal end was left open. The transverse abdominal fascia was incised circumferentially at the opening of the internal ring and the extraperitoneal fat was seen, and the anterior peritoneal space was fully freed and a D10 patch was placed, which was spread in the anterior peritoneal space and the lower end reached the posterior pubic bone. The operation was completed. The special feature of this case was that the spermatic cord adhesions caused by sclerotherapy were difficult to free and lift, and it was not possible to perform a flat patch repair of the posterior wall of the inguinal canal, so we tried to avoid freeing the spermatic cord and directly opened the transversal abdominal fascia from the internal ring opening to enter the anterior peritoneal space and perform an anterior peritoneal space repair, which simplified the operation, reduced trauma, shortened the operation time, and avoided the patch repair of the posterior wall of the inguinal canal. spermatic cord adhesions, reducing the patient’s postoperative pain and avoiding the associated complications. Now in the treatment of inguinal hernia, surgery is the only and effective way to treat hernia, but still some unregulated medical institutions use sclerotherapy, which not only fails to relieve the patient’s pain, but also brings many complications, causing more pain to the patient and making future surgical treatment more difficult, increasing the risk and complications of surgery. It is really undesirable!