The findings show that open tension-free mesh-plug hernia repair, TAPP, and TEP are safe and effective for patients with primary unilateral inguinal hernia. Both TAPP and TEP are superior to open repair in terms of less postoperative pain and faster recovery time. The authors therefore recommend laparoscopic repair techniques as the preferable choice of surgical procedure. However, they think open repair will remain a practical solution in China because of its lower cost, short learning period, and need for no special equipment.