To evaluate the clinical effect of ultraminimally invasive small incision in the treatment of pediatric inguinal hernia. Methods 197 cases of pediatric inguinal hernia were treated with minimally invasive small incision in the lower abdomen, age 7 months to 3 years, average 2.6 years. Results The surgical procedure was smooth, the operation time was 9-25min, average 19min, no recurrence in 197 cases discharged from hospital 2-3d after operation, no complications such as incision infection, spermatic cord torsion and testicular atrophy, small incision scar, and good cosmetic effect. Conclusion This procedure has many advantages, the operation is simple, the incision is ultra-small, no scar, the pain produced is light, the damage caused is small, the patient’s recovery is very fast, the operation time and hospitalization time are very short, the cost is relatively low, the efficacy of this procedure is reliable, and it’s very safe, there are few complications after the surgical treatment, and the recurrence rate of the disease is low, etc., which is very worthwhile to promote the use of the procedure in the clinic. Inguinal hernia Inguinal hernia is one of the common pediatric surgical diseases, mostly congenital diseases, boys are more common, the right side is more common than the left side, most of the onset in less than two years of age, the main manifestation of the inguinal area can be returned to the painless mass. The cause is due to the unclosed peritoneal sheath formed during embryonic period, if left untreated, the hernia sac will gradually increase in size and aggravate the defect of the inguinal canal, and the younger the age of the child, the greater the chances of incarceration, so it should be operated at the earliest possible time. 197 cases of pediatric inguinal hernia were treated in our department with ultratiny transverse incision of the lower abdomen from 2007 to 2013, with satisfactory results, which are now reported as follows. 1, Data and methods (1) General information There were 197 cases of children in this group, aged from 7 months to 3 years old, with an average of 2.6 years old, male, 190 cases, female, 7 cases. There were 180 cases of unilateral, including 25 cases of left side, 155 cases of right side and 17 cases of bilateral. There were 3 cases of incarcerated hernia. (2) Surgical methods After ketamine anesthesia, the child was placed in a supine position, the operating area was sterilized with iodine, a transverse incision of about 0.6-1.0 cm was made perpendicular to the direction of the external ring, and the skin and subcutaneous tissues were incised sequentially along the skin and subcutaneous tissues, and hemostatic forceps were used to alternatively open the subcutaneous tissues of the patient to the external oblique muscle area, and then the tendon membrane of the external abdominal oblique was lifted up with mosquito vascular forceps, and the tendon membrane of the external abdominal oblique was incised. Cut the tendon membrane of the external abdominal oblique muscle to reveal the external ring, find the position of the spermatic cord, find the hernia bundle in the medial side of the spermatic cord, if the hernia sac is large and leads to the scrotum, then it is necessary to transverse the hernia sac, free the hernia sac to the neck, such as the hernia sac is smaller, then no need to transverse the hernia sac will be free to the neck directly, the hernia sac will be unfolded with a small round needle, No. 4 thread in the neck of the hernia sac for the high position of the internal purse suture, and then ligation of a ligation, and cut off the excess of the hernia sac. If the opening of the inner ring is too large, 1 or 2 stitches can be repaired. If the outer ring is large, it should also be closed with 1 or 2 stitches so that it can accommodate the tip of the index finger. After complete hemostasis, checking for no active bleeding, and counting gauze and instruments for accuracy, the testicle should be checked at this time to see if it is in the scrotum, and if not the testicle should be placed back in the scrotum. The external abdominal oblique muscle fascia is closed with 1 stitch, 1 to 2 stitches in the subcutaneous layer, and the skin is glued with tissue glue. No use use antibiotics after surgery. 2, the results of the operation The process of the operation was very smooth, the time of the operation was 9-25min, average 19min, the day of the operation, after awake from anesthesia, you can eat fluids. On the same day, the patient could get out of bed and eat normally. The patients were discharged from the hospital 2-3d after surgery. The postoperative follow-up period ranged from six months to seven years, during which there was no case of recurrence. There were no cases of scrotal swelling, no complications such as incision infection, spermatic cord torsion and testicular atrophy, etc. The incision scar was extremely small and almost invisible, and the cosmetic effect was good. 3, Discussion Pediatric inguinal hernia is is a common and frequent disease in pediatric surgery, which is caused by congenital developmental abnormalities . When the embryo is developing, the peritoneum forms a pouch-like protrusion from the inside out in the inguinal area called the peritoneal sheath protrusion, which descends along the testicular lead that connects the testis to the base of the scrotum. As the sheath protrusion descends the testis descends into the scrotum. During normal development, the sphincter gradually becomes atrophied and occluded around the time of birth. The peritoneal sphincter attached to the testis does not become occluded and forms the sphincter lumen intrinsic to the testis, which is no longer connected to the peritoneal lumen. If there is a developmental abnormality and the peritoneal sheath remains open or partially open without occlusion, the contents of the abdominal cavity enter under the influence of certain triggers, such as coughing, crying, constipation, etc., and a congenital inguinal hernia is formed. The main reason for the development of inguinal hernia is that the peritoneal sheath is not occluded, coupled with coughing, crying, constipation and other factors lead to increased abdominal pressure, resulting in the development of the disease. inguinal hernia in infants and young children older than 6 months of age has very little chance of healing on its own, and therefore requires surgical treatment. Previously, most hospitals used a transverse inguinal incision, 3-5cm long, this surgical method has the disadvantages of large damage, bleeding, long operation time, obvious scar, easy to damage the ilioinguinal nerve, ilioinferior inguinal nerve and so on. The pediatric inguinal canal is short and flat, and the inner and outer rings basically overlap, so a transverse incision directly to the hernia sac can be applied to perform high hernia sac ligation. Combined with this group of cases, the author has obtained the following experience: ① Previously reported small incision treatment of pediatric hernia, the surgical incision are reported to be about 1.0-1.5cm long, the author of the first time in China to put forward the concept of ultra-micro-incision, to do the hernia sac 0.6-1.0cm high ligation. The age requirement is preferably under 3 years old, and the body type is not too obese. ③This procedure has a simple approach, less tissue damage, does not destroy the original structure of the inguinal canal, so it is not easy to damage the ilioinguinal nerve and iliohypogastric nerve. The postoperative scar is very small, almost invisible after 3 months, the operation time and hospitalization time are very short, the cost is low, the treatment effect is safe and reliable, and there are few complications and low recurrence rate, which makes it worthwhile to be widely applied in clinic and meets the requirement of minimally invasive. ④ However, the procedure is demanding on the operator, requiring a high degree of familiarity with the anatomy of the inguinal canal and the ability to locate the hernia sac and present the incision in 1 pass. Conventional high hernia sac ligation surgery parallel to the inguinal canal approach has been gradually replaced by minimally invasive surgery because of its time-consuming, greater injury, more complications, and higher recurrence rate. Minimally invasive technology represented by laparoscopy is also difficult to promote because it usually requires 3 holes to be punctured in the abdomen, and even if there is only one hole to improve the surgery, it still needs to enter into the abdominal cavity to operate, which increases the risk of the surgery, and requires perfect operating instruments and higher treatment cost, and also requires the operator to master the laparoscopic operation technique. Minimally invasive technology for pediatric inguinal hernia diagnosis and treatment, for patients and families is “minimally invasive scar”, the surgical process of the body of the small blow, less damage, do not need to strip the spermatic cord, so as to avoid the destruction of the anatomical structure of the inguinal canal of the abdominal wall of the blood vessels, the vas deferens and spermatic cord vascular damage, the operation of the pain is relatively light, no localized. The pain of the surgery is relatively light, there is no local tugging sensation, the recovery time is shorter, the recurrence rate is lower, which reduces the pain of the children, and the minimally invasive method with ultra-tiny incision is used in the diagnosis and treatment of children’s inguinal hernia instead of the traditional surgery, which is beneficial to the children and their families.