The traditional inguinal hernia surgery is represented by the Bassini operation, this kind of repair surgery in order to strengthen the abdominal wall, repair defects, the different tissue structure and anatomical level of tissue structure forcibly suture together, will inevitably cause the local tissue and suture tension is too high, may produce tissue tear, suture breakage, and ultimately lead to the abdominal wall defects and recurrence again. 1989 Lichtenstein, the United States, first proposed the concept of “tension-free hernia repair surgery”. In 1989, Lichtenstein first put forward the concept of “tension-free hernia repair surgery”, from the inguinal hernia repair has entered the tension-free era, the scientific application of biological repair materials significantly reduce the recurrence rate of hernia after surgery, postoperative complications have also been significantly reduced. Currently commonly used hernia repair patch materials include polypropylene, polyester and expanded polytetrafluoroethylene, etc. Polypropylene material is the most commonly used in clinical application because of its advantages of firmness, economy, and good handfeel. Newer lightweight patches and biopatches have obvious advantages in terms of postoperative pain, foreign body sensation and anti-infection. In the 1950s, Dr. Fruchaud of France created the concept of “myopectineal orifice” (MPO), which is an oval-shaped fissure located at the level of the anterior wall of the lower abdomen connected to the pelvis. This area has only the transversal abdominal fascia to resist intra-abdominal pressure and is the anatomical basis for the development of all types of inguinal hernias. The preperitoneal hiatus (Bogros’ hiatus) surgical approach is based on this anatomical level and is the anatomical basis for this new surgical approach. Preperitoneal hiatus hernia repair involves the placement of a patch into the gap between the transversal abdominal fascia and peritoneum in order to achieve a comprehensive repair of hiatal, rectal, and femoral hernias in the inguinal region. In 2005, Huang et al. published a controlled study in which he compared the early and mid-term efficacy of Priligy PHS repair with that of mesh-filled hernia repair, and concluded that both surgical procedures were shorter, less invasive, with quicker recovery time, and no postoperative recurrence, but the PHS procedure required a longer surgical time than the mesh-filled procedure, and the incidence of postoperative chronic pain was significantly lower in the former than in the latter, which he considered to be safer and more efficacious than the latter. procedure is safer and has more reliable efficacy than the latter. In China, Zheng Jingjing et al. retrospectively studied 453 inguinal hernia repair patients (230 cases in the preperitoneal repair group and 223 cases in the mesh plugging repair group), and concluded from the comparison of the two surgical modalities that anterior approach preperitoneal repair has a lower incidence of foreign body sensation and recurrence than hernia ring filling repair, and it is a more desirable surgical modality for inguinal hernia. We found that both procedures had effective surgical outcomes and fewer postoperative complications. Among them, there was no significant difference in operative time, postoperative time out of bed and average hospitalization days, but there were significant differences in bleeding and hospitalization costs. We analyzed the main reasons for less bleeding in preperitoneal hiatus repair: the preperitoneal hiatus is located between the posterior layer of transversus abdominis fascia and the wall peritoneum, which is composed of loose adipose tissue and is a bloodless hiatus; there is no need to free the spermatic cord throughout the operation, and there is less damage to spermatic cord blood vessels and nerves. However, the cost of PHS patch is significantly higher than that of mesh-plugged patch, so the hospitalization cost of the former is significantly higher than that of the latter. The preperitoneal hiatus repair was less painful than the mesh-plugged patch in terms of VAS scores at 24h and one-week postoperative observation. It was found that the occurrence of postoperative pain after inguinal hernia is mainly related to surgical trauma, entrapment, clamping or severing of nerves in the inguinal region, injury to the pubic tubercle membrane, and compression of the spermatic cord by the patch and intra-incisional hematoma. Anterior peritoneal gap repair is performed by placing a patch into the anterior peritoneal gap, which does not require suture fixation after placement; and the spermatic cord does not need to be freed throughout the operation, so the incidence of postoperative pain is lower than that of mesh plug-filled repair. Both preperitoneal and mesh-filled patches can be used in adult inguinal hernia repair, and both have the advantages of shorter operation time, faster postoperative recovery and lower recurrence rate. Especially prominent is: preperitoneal gap repair in the patch can completely cover the pubic ramus, so it can cover almost all the incidence of abdominal wall hernia; through the reconstruction of the transversus abdominis fascia, from the root to correct the etiology of the abdominal wall hernia; repair method is more in line with the principle of physics, and at the same time, the patch position is deeper, less foreign body sensation, and is not easy to displace, so this procedure is becoming the first choice of the inguinal hernia repair procedure. However, because of the high cost of the patch required for the anterior peritoneal space, the total cost of hospitalization is slightly higher. It is believed that with the continuous research and development of new materials, the ideal patch that is more affordable can appear in the future, and the anterior peritoneal space patch repair surgery will have a better future.