Rethinking about the reasonable choice of laparoscopic inguinal hernia repair        LI Jian-wen, ZHANG Yun. Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Clinical Minimally Invasive Surgery Center, Shanghai 200025, China
Corresponding author: LI Jian-wen, E-mail: ljw5@yeah.net
Abstract    The tension-free inguinal hernia repair can falls into three different surgical techniques including premuscular repair, plug and patch repair and preperitoneal repair. The method of first two repairs the posterior wall of the inguinal canal and the hernia defect, and the latter repairs all of the weak area of the groin area, that is myopectineal orifice. Preperitoneal repair can be achieved through open surgeries or laparoscopic approach. Actually, laparoscopic inguinal hernia repair (LIHR) is one of the preperitoneal repair, which is through “real posterior approach”, under “direct vision” and by the “laparoscopic instruments”. The three clinical suitable crowd: (1) The patients with preperitoneal repair indications, such as the patients with old aged and the transversalis fascia feebleness, direct hernia or complex hernia and the abdominal cavity internal pressure increased and so on; (2) The patients need recover physical activity as soon; (3) Recurrent and bilateral inguinal hernia patients. Laparoscoic and open surgery are both safe and efficient tension-free techniques for inguinal hernias repair. The reasonable choice of repair method can offer the best clinical and cost-effective results.