探讨腹腔镜全腹膜外腹股沟疝无张力修补手术（TEP）腹膜前空间区域解剖结构及术中应用精细解剖结合钝性分离方法和腹膜切开技术对手术影响。

回顾分析2013年5月至2015年5月间施行腹股沟疝手术患者的手术记录及患者资料，体会手术要素口诀：一个技巧/技术，两个解剖，三个间隙，四个区域。

120例患者按解剖顺序游离腹膜前区域，采用超声刀精细分离结合棉纱条钝性分离方法和疝囊切开技术完成TEP手术；手术时间50~100 min，出血量10~30 ml；术后患者第1天下床活动，无明显疼痛及牵拉不适，平均住院（6±1）d；2例出现血清肿，1例出现皮下淤血，1例出现阴囊血肿，1例外环口处血肿，经对症治疗后好转，无严重并发症；术后远期随访4~24个月，无一例出现复发。

TEP手术具有创伤小、恢复快、切口美观、住院时间短等优点，术后补片与组织融合，强度显著增强，既符合腹股沟疝无张力修补原则，又符合人体生理解剖结构。只要熟练掌握腹膜前区域空间膜的解剖结构，配合手术技巧，按区域顺序规范操作，就可缩短手术学习曲线，保证手术安全，减少并发症，值得各级医院推广应用。

To investigate the regional anatomy of the preperitoneal space in the laparoscopic totally extraperitoneal (TEP) inguinal hernia repair, and to define anatomical structure according to different regions.

By reviewing and analyzing the surgical records and data of one hundred and twenty patients with inguinal hernia from May 2013 to May 2015 in our hospital, we grasp the surgical elements: one skill/technique, two anatomies, three intervals, and four regions.

By anatomy order, all patients underwent operations with ultrasonic knife fine separation, veil strip blunt division and peritoneum incision technique, operation time lasting for 50-100 minutes and bleeding of 10-30 ml. The majority of patients had off-bed activities the first day postoperatively, without obvious pains and discomforts. The average length of hospital stay was (6±1) days. Postoperative follow-up lasted from 4 to 24 months, with two cases of seroma, one case of subcutaneous congestion, one case of a small amount of scrotal hematoma, an outer ring road hematoma, all improved after symptomatic treatment, and no severe complications were observed.

Laparoscopic TEP has little trauma, fast recovery, good incision, shortened length of hospital stay, with mixed patches and tissues mixed to enhance the intension significantly. It is consistent with the principles of inguinal hernia tension-free repair and the anatomy structure of the human physiology. Once the anatomy of the peritoneal membrane regional space and intergrating surgical techniques are mastered, the standardized operation will shorten the learning curve, ensure surgical safety and reduce complications. It is worthy of popularization and application in hospitals at different levels.