Recently, a patient with bilateral inguinal hernia, aged 79 years old, male, was admitted to our department. He was found to have bilateral inguinal reversible masses for more than 3 months. The patient had been smoking since the age of 11 and was now smoking more than 2 packs per day. Therefore, the presence of a heavy chronic obstructive pulmonary disease created a lot of problems for surgery, and it was necessary to choose a treatment method that was concise, minimally invasive, quick, with definite efficacy, low recurrence rate, and able to cover the whole inguinal area defect. As the Department of Surgery 1 is skilled in the cutting-edge open complete extraperitoneal inguinal hernia repair (TEP) technique, Director Wang Hong led the subordinate physicians and fully prepared to successfully perform the operation on this patient recently. Complete extraperitoneal inguinal hernia repair (TEP) was originally one of the standard procedures for laparoscopic hernia repair, which was established by Dr. Mckernan of the University of Kentucky in 1993. It was later extended clinically to an open TEP procedure in which a small median incision is made in the lower abdomen under direct vision to perform a tension-free repair of bilateral hernias. This posterior median approach to the lower abdomen with a small incision for bilateral inguinal hernia repair has been refined and is now a cutting-edge, well-established procedure. Clinical practice has shown that the open TEP approach is simple, quick and effective. It does not require high requirements for surgical instruments, has good results, and is easy to promote. Surgical principle: Open complete extraperitoneal inguinal hernia repair (TEP) surgery is a posterior approach to preperitoneal repair, with a median incisional approach through the lower abdomen, in the deep surface of the rectus abdominis muscle, establishing a gap, dealing with the hernia sac, walling the spermatic cord, placing a larger patch, completely covering the presence or potential defects of the pubococcygeal muscle foramen, and fixing the mesh between the muscles of the extraperitoneal pelvic wall and the abdominal wall with the help of intra-abdominal pressure. The corresponding gap is separated in front of the peritoneum, and no sutures are needed to fix the patch, so it is not complicated and time-consuming. The indications for surgery are broad and include: bilateral inguinal hernia, hiatal hernia, femoral hernia, complex inguinal hernia including giant hernia, hiatal hernia, multiple hernia, recurrent hernia, incarcerated hernia, etc. in adults. The requirements for anesthesia are not high, and various methods such as epidural anesthesia, lumbar anesthesia or local nerve infiltration anesthesia can be selected according to the patient’s physical condition and underlying disease. Features of this procedure: (1) The surgical approach is an anterior peritoneal hernia repair, just like the TEP approach, which is conceptually more reasonable, with the patch placed in the anterior peritoneal space (Bogros space) and covering the entire pubococcygeal foramen to achieve a total inguinal repair. It is especially suitable for huge hernias, hiatal, straight or compound hernias with severe transversal abdominal fascia defects. (2) Single incision for simultaneous repair of bilateral inguinal hernias is simple, without incision of the extra-abdominal oblique tendon membrane, without dissecting the inguinal canal, minimally invasive, avoiding damage to nerves and vas deferens, and without affecting the internal ring of the inguinal canal “Shutter” (Shutter) and “sling (2) The inguinal canal is minimally invasive, avoiding damage to the nerves and vas deferens and not affecting the “Shutter” and “sling” closure mechanisms of the inguinal canal. (3) The anterior peritoneal space (Bogros space) is a relatively nerve-free level, and the patch placed in this space can be fixed without displacement by the action of intra-abdominal pressure, reducing sutures, significantly reducing the incidence of postoperative chronic pain and testicular inflammation, and minimizing surgical trauma. (4) It is more suitable for recurrent hernia after conventional open surgery, which is entered from the posterior side of its original surgical maneuver, avoiding the scar in the original inguinal area, with clear surgical access and reduced surgical difficulty. (5) Those with a history of lower abdominal surgery can be entered through the original incision without the need to reselect the incision. It is also possible to perform hernia repair at the same time as other lower abdominal surgeries. In conclusion, the introduction and successful implementation of this new technology has enriched a whole new connotation for the development of hernia and abdominal wall surgery in our Department of Surgery 1, and the technology has reached the national leading position.