Inguinal hernia is a common disease in pediatric surgery, with a prevalence of (10-20)/1000 in children, and since its formation is not due to a weak abdominal wall but to incomplete atresia of the sphincter, routine laparoscopic high ligation of the internal ring has been well proven to be a safe and effective procedure after extensive clinical practice. It has the following advantages: ① The anatomy of the pediatric groin is clearly exposed laparoscopically, avoiding the damage that may be caused by traditional surgical dissection of the inguinal canal. ②A true high level ligation can be achieved. ③It can detect and deal with contralateral occult hernia at the same time. 8 cases of occult hernia were found in our group and high ligation was performed at the same time. ④Small postoperative scar, light pain, quick recovery and short hospital stay. ⑤ The recurrence rate is relatively low. Although conventional laparoscopy has many advantages, there are still some shortcomings. Generally, the operation requires the placement of the optoscope and instruments through two holes to activate three holes, multiple postoperative scars, relatively poor cut concealment effect, which may have certain impact on the psychological development of the child, especially when the contralateral cryptic hernia is found, it is often necessary to add a poke hollow, although the poke hole is very small, but it is still traumatic. The transumbilical single-hole laparoscopy (E- NOTES) we perform for pediatric inguinal hernia not only minimizes the number of abdominal wall incisions and reduces trauma, but also achieves the best concealed effect after healing of the transumbilical margin incision, which is incomparable to other procedures in terms of cosmetic effect. Of course, compared to conventional laparoscopy, E- NOTES still has some problems that need to be solved. In particular, due to the centralization of the surgical instruments, the mutual obstruction of the instruments has different degrees of impact on the maintenance of the pneumoperitoneum, the exposure of the surgical site, anatomy and illumination. Our experience is that the rectus abdominis muscle and the anterior sheath are used to prevent pneumoperitoneum leakage, i.e., the two pokes at the umbilical rim are initially unconnected and divided by the rectus abdominis muscle, i.e., the sheath; and the two Trocar diameters are the same, which facilitates left-right interchange without adding additional punctures; and the two Trocar lengths are different, which avoids the concentration of instruments crowding each other and affecting intraoperative operations. In terms of NOTES technology, this procedure can achieve the effect of hiding the abdominal scar and avoiding the problem of infection through the cavernous organs, and it also allows the use of traditional laparoscopic instruments. Therefore, E- NOTES for pediatric inguinal hernia, as a less invasive minimally invasive technique, gives clinicians a new choice in the treatment of pediatric hernia. It is believed that with the advancement of technology and the maturity of instruments and equipment, single-port laparoscopic surgery for pediatric hiatal hernia will be further popularized through clinical research and practice.