By understanding the anatomy of the inguinal membrane, the correct level of open anterior peritoneal approach can be identified to reduce the postoperative recurrence rate and complications.

From January 2006 to March 2018, 450 patients with primary inguinal hernia in Dongguan Chashan Hospital were enrolled for intraoperative observation, histological analysis and long-term follow-up.

The inguinal canal has two internal rings (the middle ring and the inner ring). The "portal" into the Bogros space is between the peritoneum and the deep layer of the preperitoneal fascia, while the layer into the Retzius space is between the transverse abdominal fascia and the superficial layer of the preperitoneal fascia. These two discontinuous membrane layers are connected in the preperitoneal space by cutting the interstitial ligament of the inferior epigastric vessels. The average follow-up time was 53 months. The incidence of chronic pain and the recurrence rate were less than 1%.

Understanding the anatomy of the inguinal membrane structure is helpful to improve the safety and reliability of open preperitoneal hernia repair and reduce the surgical complications and recurrence rate.