To investigate the clinical efficacy of laparoscopic totally extra-peritoneal hernia repair (TEP), laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) and open tension-free repair (OTFH).

578 inguinal hernia patients who underwent surgery in Shenzhen Nanshan District People's Hospital, were enrolled from January 2014 to April 2018. They were divided into TEP group, TAPP group and OTFH group according to the surgical method. The surgical conditions, postoperative pain, complications, hospitalization costs and recurrence of patients in the three groups were compared.

The operation time, intraoperative bleeding, postoperative pain score, complications and recurrence rate of TEP group and TAPP group were significantly lower than those of OTFH group (P<0.05), but the cost was significantly higher than that of OTFH group (P<0.05). The TEP group was significantly superior to the TAPP group in terms of operation time and intraoperative bleeding (P<0.05), and there were no statistical differences in operation cost, complications and recurrence rate between the TEP group and TAPP group (P>0.05).

TEP, TAPP and OTFH are safe and effective operation methods in hernia surgery, TEP has obvious advantages in operation time and intraoperative bleeding, and it has the best medical experience for patients with inguinal hernia. However, the operation requirement is higher. Surgical advances are needed to further shorten the learning curve.