To observe the anatomical structures of the posterior wall of inguinal region in the view of laparoscopy, and to explore the main points and difficulties of the laparoscopic posterior approach to the preperitoneal inguinal hernia repair.

To collect and collate the video data of 1500 cases of laparoscopic inguinal hernia repair (LIHR) from January 2013 to December 2018 in Wuhan No.1 hospital, and summarize the surgical approaches, anatomical signs, operating key points of laparoscopic totally extra-peritoneal (TEP) and laparoscopic trans-abdominal preperitoneal hernia repair (TAPP).

In 1500 cases of LIHR, there were 660 cases of TEP and 840 cases of TAPP. TEP and TAPP methods had different surgical approaches, two modes of operation were in the preperitoneal space (including the Retzius and Bogros space); the two surgical methods need to identify the same anatomical signs: such as the pectineal ligament, the inferior epigastric vessels, the spermatic cord structure or the round ligament of the uterus, the Doom triangle, the corona mortis, the external iliac vessels, lateral femoral cutaneous nerve and genitofemoral nerve; the two kinds of surgical methods need to separate enough range of the preperitoneal space, correctly separate the hernia sac, complete the deperitonealization to spermatic cord, and fully cover the whole myopectineal orifice (including the inner ring, Hesselbach's triangle and femoral ring) with the polypropylene mesh of 10 cm×15 cm.

The operation of TEP and TAPP are effective methods of LIHR. Familiarity with anatomical features of the posterior wall of the inguinal wall in the view of laparoscopy is beneficial to shorten the learning curve of LIHR and better grasp the operation.