To investigate where is the suitable anatomical locations to cut off in the surgical treatment of adult inguinal hernia with giant hernia sac.

127 patients with giant inguinal hernia sac were selected in the First Affiliated Hospital of Chongqing Medical University from Mar 2014 to Aug 2016. Finally, 106 patients were included. All of them were divided into two groups randomly. All of the selected patients underwent the Lichtenstein's operation. In the group one with 54 patients, we cut off the hernia sac closed to the internal inguinal ring. And in the group two with 52 patents, we cut off the hernia sac closed to the external inguinal ring. Then the operation duration, bleeding volume, edema degree of scrotum, volume of drainage of the incision, and postoperative chronic pain were compared.

All of the operations were completed successfully. Group one had less complications in edema degree of scrotum and volume of drainage of the incision than group two. The result had statistical significance (P<0.05). But the differences of operation duration, intraoperative bleeding and postoperative chronic pain had no statistical significance (P>0.05).

In the operation of inguinal hernia with giant hernia sac, it can result in less complication by cutting off the hernia sac closed to the internal inguinal ring and leaving the distal part of the sac where it was.