Inguinal hernia is a common disease in general surgery, hernia repair is also one of the commonly performed procedures in general surgery, traditionally for more than 100 years, the hernia sac is ligated through the inguinal incision and tenosynovial reinforcement of the hernia sac, there are dozens of types of repair and other traditional methods, in the past three decades there is a wide range of tension-free hernia repair and laparoscopic hernia repair, in the face of a number of surgical modalities, the use of which surgical modality, has become the focus of the debate! The focus of the debate is on which surgical procedure to use. Traditional hernia repair includes the Bassini method, Halsted method, McVay method, Ferguson method and other high-tension repair, and Shouldice low-tension repair. 1887, Bassini successfully completed the first case of hernia repair, i.e., after ligating the hernia sac in a high position and lifting up the spermatic cord, the lower edge of the internal oblique muscle and the conjoint tendon were stitched to the inguinal tendon in the posterior part of the hernia. Bassini’s hernia repair is regarded as a classic procedure and is still in use today.McVay’s method involves suturing the lower edge of the internal oblique muscle and the conjoint tendon behind the spermatic cord to the pubic symphysis pubis ligament.McVay’s method is used in patients with large hiatal hernias, recurrent hernias, and rectal hernias.The above hernia repairs are performed with existing hernias. These hernia repairs are performed using adjacent tissue that is already defective; the forced closure of tissue that is not in its normal anatomical position is very stressful and does not conform to surgical principles. There is a high incidence of recurrence and complications after hernia repair. The above hernia repair is still satisfactory in some patients, mostly used for young patients with small defects and sound transversal abdominal fascia, otherwise tension-free hernia repair is preferred. Otherwise, tension-free hernia repair is preferred. The recurrence rate can be kept at a low level by strictly controlling the indications for surgery. The recurrence rate after conventional hernia repair in our patients was <2%, which may be related to the selection of patients, and the long-term recurrence rate may be higher due to the short follow-up period. In contrast, the recurrence rate after conventional hernia repair was previously reported to be 10-30%. Gilbert's method of tension-free hernia repair uses an umbrella-shaped polypropylene mesh to fill the defect, which can be automatically opened and quickly attached to the surrounding tissues after being inserted into the defect, and then the mesh is placed to strengthen the posterior wall of the inguinal canal, and the mesh and the filling do not need to be secured with sutures. Gilbert's method is easy to operate, little injury, clinically proved not only less complications, low recurrence rate, and for the treatment of large hiatal hernia and other types of inguinal hernia also achieved good results, is currently widely used surgical methods. However, for abdominal wall defects larger than 5cm or for young people, it is best not to use this procedure. Mesh plugs cannot fill large defects well; they can cause complications, including sexual dysfunction and painful ejaculation. The Lichtenstein tension-free inguinal hernia repair, proposed by Lichtenstein in 1984, is a popular method of inguinal hernia repair. The procedure involves placing a patch between the internal oblique muscle and the inguinal ligament to strengthen the posterior wall of the inguinal canal, and the spermatic cord passes through the mesh anteriorly, emphasizing the reconstruction of the internal ring with the mesh. The hernia sac of hiatal hernia was free in high position, and the hernia sac of rectal hernia was closed by continuous internalized suture. Compared with traditional hernia repair surgery, this method has the following advantages: (1) the use of local anesthesia, can be completed in the outpatient clinic; (2) fewer surgical complications, postoperative pain is mild; (3) the patient's braking time is short; (4) the postoperative recurrence rate of no more than 1%. This repair is mainly indicated for: (1) adult incipient inguinal hernias; (2) recurrent hernias with defects greater than 3.5 cm. Some authors believe that in elderly patients and recurrent patients Lichtenstein is by far the most ideal method. The main advantages of various tension-free hernia repair styles are simplicity of operation, high safety, rapid postoperative recovery, short hospitalization, completion of the operation under local anesthesia in outpatient clinics in most cases, economy, permanent strengthening of the posterior wall of the inguinal canal, and a low rate of postoperative recurrence (<1%). Therefore, this method is accepted by more and more surgeons. In the past, the postoperative recurrence rate was the only criterion for the efficacy of hernia surgery. Currently, both domestic and foreign data show that many classical and modern tension-free repairs are very effective in terms of hernia recurrence. This also shows that we can no longer rely on the postoperative recurrence rate as the only indicator of hernia efficacy. We are now in the era of evidence-based medicine (ebm), where patient participation and patient response are essential in evaluating the efficacy of hernias. In one study, about 5% of all patients who underwent hernia surgery with artificial material implantation had postoperative discomfort that exceeded their preoperative discomfort when the hernia was present, which means that the efficacy of hernia repair cannot be based on recurrence alone at this time. There is also increased concern about male sexual function and reproduction after inguinal hernia repair, which has been poorly documented in the literature. The large patches used in conventional suture and tension-free hernia repair can eliminate the anterior bladder space, which can produce an imbalance in sexual and reproductive function in the anterior space. The consequence of this is that it may affect male urinary and sexual function. However, for a long time, doctors and patients failed to pay attention to it. The prospect of laparoscopic hernia repair (lhr) depends on its relative superiority to open tension-free hernia repair. Reducing the cost of surgery and adopting a new procedure that does not require general anesthesia are the main factors promoting the development of laparoscopic hernia repair, but its unique surgical complications and its long learning curve for physicians have also limited the development of lhr. The advantages and disadvantages of conventional hernia repair, i.e., anterior tension versus tension-free hernia repair, are also a difficult issue to determine. Some authors have argued to the contrary, that tension-free hernia repair has its own complications and risks, that it does not change the recurrence rate of recurrent hernias, and that it only prolongs the recurrence time of primary hernias, and that it is not appropriate to use tension-free hernia repair for all patients in order to achieve a recurrence rate of about 15% with conventional hernia repair. Long-term clinical randomized studies are needed. In addition to the choice of surgical modality, there are several issues that need to be standardized, such as the choice of anesthesia for surgery and other specifics. For high abdominal pressure diseases that need to be eliminated by surgery (e.g., prostatic hyperplasia) whether two surgeries can be performed at the same time, there are in favor. However, the clinical approach is mostly to perform a split operation. In conclusion, the repair of inguinal hernia in adults should be based on the specific situation of the patient, the correct assessment of preoperative and intraoperative defects, and follow the principle of individualized repair, there is no golden operation suitable for all patients, and it is different from person to person in order to control the postoperative complications to a low limit.