Inguinal hernia is the most common surgical condition in pediatric patients and is caused by congenital unclosed sheath hernias, which are almost always inguinal hernias. Hernia repair accounts for about 15% of all pediatric surgical procedures. The classic procedure of transversal herniotomy and internal ring ligation has been used until now. Although the recurrence rate is not high (<1%), open surgery requires dissection of the inguinal area to separate the hernia sac from the spermatic cord vessels and the vas deferens, which inevitably results in injury and causes scrotal hematoma or edema, and even triggers cryptorchidism of medical origin. In the past 20 years, as the feasibility and safety of laparoscopic technology has been confirmed in the course of pediatric surgical practice, its advantages of not dissecting the spermatic cord, identifying contralateral cryptogenic hernia, and being able to deal with both sides of the unclosed hernias have been rapidly carried out all over the world, and the surgical procedures have been continuously improved. The diagnostic value of laparoscopy (Laparoscopic diagnosis) is further enhanced by the use of probes, endoscopic hooks, or other ancillary instruments to further improve the effectiveness of laparoscopy in the diagnosis of suspected unclosed sheath hernias. Thus, the sensitivity of laparoscopic diagnosis of an unclosed sheath is 99.4% and the specificity is 99.5%, making it the gold standard for the diagnosis of inguinal hernia. Differences in the morphology of the inner ring, as well as the scale of the inner ring for determining whether a hernia can be formed by sphincter hernia, can be evaluated laparoscopically, which is also a guide for those sphincter hernias that should be treated surgically. Therefore, the study not only demonstrates the timely effectiveness of laparoscopic surgery, but also puts an end to the debate about the need to explore the contralateral groin for suspected syringomyelia. In addition, laparoscopic techniques can clarify the lesion characteristics of suspected recurrent and strangulated hernias, rare straight and femoral hernias in pediatric patients, and other concomitant abnormalities. Laparoscopic inguinal herniorrhaphy was first performed in 1990 by Ger et al. using metal clips to close the beagle's internal ring laparoscopically, demonstrating the feasibility of this type of surgery, thus beginning the era of laparoscopic techniques for the treatment of pediatric inguinal hernias. Based on the method of closure of the internal hernia ring can be categorized into intraperitoneal and extraperitoneal ligation, with the former requiring intraperitoneal trocars or sutures (transection or no incision of the internal ring), and the latter requiring extracorporeal ligation or sutures to complete the procedure. In addition, it can be categorized into three-hole, two-hole and single-hole techniques based on the number of trocars. Three-port laparoscopic techniques Laparoscopic inguinal hernia repair was initially restricted to girls due to concerns about damage to the spermatic cord structures. In 1997, El-Gohary was the first to report on internal inguinal hernia ligation in girls, and the subsequent use of this technique in boys demonstrated that the technique did not cause significant damage to either recurrent or incarcerated hernias. Subsequently, it has been demonstrated in boys that this technique does not cause damage to vital structures, either in the treatment of recurrent or incarcerated hernias. Inverted sac with the internal ring endolooping is performed by placing a grasping forceps in the trocar on the affected side and pulling the hernia sac from the bottom of the sac into the abdominal cavity and turning it inside out, and then placing an endoloop in the opposite side of the trocar and ligating the neck of the hernia sac without the need for microscopic sutures and knots, and is indicated only in female children who do not need to be dissected for inguinal structures. Pure suturing of the inter-nal ring is the most commonly used method for early laparoscopic hernia repair. The inter-nal ring is sutured without the need to separate the hernia sac, and the ring is closed intra-abdominally with interrupted "Z" or continuous purse-string sutures. Usually only the peritoneum is sutured, and this method requires specialized techniques for in vivo suturing. In the beginning, there was a high recurrence rate (3%-5%) due to omission of this peritoneal space during suturing for fear of damaging the vas deferens or genital vessels. In order to make the surgery safer and reduce the recurrence of hernia, Chan et al. used the technique of injecting water into the extraperitoneal space to separate the peritoneum of the posterior wall of the inner ring from the spermatic vessels and the vas deferens, so that the hernia defect could be completely closed without tension, thus significantly reducing the recurrence rate. Hernia sac transection and intracorporeal ligation Because of the high recurrence rate of simple intracorporeal ligation, Becmeur et al. in 2004 followed the principles of open hernia surgery by transecting the hernia sac and suturing the intracorporeal ligation, and in 2012, Boo et al. reported that there were no postoperative recurrences in 202 cases. The procedure is essentially the same as conventional open surgery except that the groin does not have to be opened. Due to the need for dissection of the internal ring, this procedure requires a higher level of microscopic skill. Flip-flap herniorrhaphy (Flip-flap herniorrhaphy) involves anatomical separation of the peritoneum anterior to the hernia sac and the lateral half of the hernia sac to the medial side to cover the hernia defect with sutures. The formation of a unidirectional flap of the peritoneum prevents entry of intra-abdominal organs into the hernia sac and permits the flow of fluid from the hernia sac into the peritoneal cavity, thus preventing syringomyelia in the postoperative period. Although this method is technically and physiologically well conceived, its safety and success rate are also questionable, as it is prone to vascular injury and flap rupture during suturing.