A protruding “swelling” grew on the right side of the waist of a 60-year-old granny Sun, and it was already two months after she discovered it because she had a fat waist. The worried grandmother suspected that she had a tumor, but the “swelling” with a diameter of more than 10 centimeters disappeared immediately when she lay down, without pain or itching, and the surface skin was normal. The “swelling” in her waist was actually a rare “lumbar hernia”, which was diagnosed by experts. According to Professor Yao Qiyuan, director of the Department of Hernia and Abdominal Wall Surgery at Huashan Hospital of Fudan University, a “hernia”, commonly known as a hernia, is a part of human tissue or organ that leaves its original site and enters another part through a gap, defect or weakness in the body. Generally, abdominal hernia is more common. Inguinal hernia: A common clinical inguinal hernia is a swelling that appears in the inguinal region due to weakness and increased intra-abdominal pressure, which appears when standing or walking and disappears after rest or lying down. These hernias can occur at any age, but the peak occurs in the early childhood, 80% – 90% occur in males (inguinal hernia), and inguinal hernias are mostly in the elderly. Incisional hernia: An incisional hernia is a hernia that occurs at the site of a surgical incision, usually in the abdomen, especially in the longitudinal abdominal incision area, and the main symptom is the appearance of a mass at the abdominal wall incision; this type of hernia occurs at the site of the original surgical incision scar. Incisional hernias may occur months or years after abdominal surgery. Stoma hernia: a special type of abdominal wall incisional hernia associated with an intestinal stoma, caused by the lateral prolapse of the small intestine or colon through the stoma for various reasons, and is one of the common complications after intestinal stoma surgery. Esophageal hiatal hernia: It is a disease caused by the entry of intra-abdominal organs (mainly stomach) into the thoracic cavity through the diaphragmatic esophageal hiatus. Esophageal hiatal hernia is the most common of diaphragmatic hernias, reaching more than 90%. Patients with esophageal hiatal hernia can be asymptomatic or mildly symptomatic, and the severity of their symptoms is independent of the size of the hernia sac and the severity of esophageal inflammation. Hiatus hernia and reflux esophagitis may coexist or be present separately. Gastroesophageal reflux disease: GERD refers to acid reflux and heartburn (heartburn) caused by reflux of stomach and duodenal contents into the esophagus. Some patients may also have extraesophageal manifestations such as non-cardiogenic chest pain, asthma, chronic cough, pharyngitis, and dental caries. It can be treated with the same laparoscopic technique as hernia. Early surgical repair Inguinal hernia, for example, is more common in men than in women; more common on the right side than on the left; constipation, difficulty in urination, chronic cough, large amount of ascites and heavy physical labor are the causative factors; in addition to local swelling, most patients have a localized sensation of swelling or mild pain. With the prolongation of the disease, the swelling is sometimes difficult to be completely retracted, which will cause certain impact on patients’ life. Some patients even have obvious local pain and abdominal pain, nausea and vomiting, etc. We call it intussusception, which is the result of the intestinal tube being stuck and unable to return to the abdominal cavity, and such patients often need emergency surgery to release the compression on the intestinal tube, otherwise the consequences are unthinkable. Therefore, the only cure for inguinal hernia is surgical repair, and therefore it should be performed as early as possible. Usually, hernia surgery requires about a week of hospitalization, but in recent years, with the advancement of medical technology, a new treatment measure has made this procedure faster and safer: day surgery. Modern technology has more advantages Day surgery has become popular in the more developed European and American countries in the last decade or so, and nearly 40% to 50% of the surgeries can be done in day surgery centers, and the most performed surgery is hernia repair surgery. The reason why this surgery has been developed so much is that, firstly, the tension-free repair with a patch (i.e., lined with a patch) makes the surgery less traumatic, safer, and the patient feels good and recovers faster after surgery; secondly, the application of laparoscopic repair technology as a minimally invasive treatment means is more advantageous for the treatment of bilateral hernia, recurrent hernia and compound hernia, etc. In recent years, Huashan Hospital of Fudan University has developed a successful approach to day surgery, in which patients are prepared for surgery in the outpatient clinic, wait for notification of admission, operate on the same day of admission or the next day, and are discharged after surgery for one day of observation, so that hospitalization takes only two days, which not only speeds up bed turnover but also allows patients to have a safe hospitalization for observation after surgery. In the treatment process, for patients in good general condition, one 1 cm and two 5 mm incisions are made by laparoscopic technique for minimally invasive repair; for elderly and frail patients with multi-systemic pathologies, local anesthesia is chosen to make an incision of about 3 cm, which can also achieve the purpose of minimally invasive treatment. All incisions are closed intradermally with absorbable sutures, and no stitch removal is required after surgery. In addition, patients with incisional and parastomal hernias can be repaired minimally invasively using laparoscopic techniques and can be discharged 3 to 5 days after surgery, with better results than traditional open surgery. Related Links Single-port laparoscopy inserted into belly button Old man’s hernia successfully repaired The first single-port laparoscopic repair of hernia in China was successfully performed in the Department of Surgery of Huashan Hospital of Fudan University. By inserting the laparoscope through the navel and performing the hernia repair, the patient’s surgical trauma was minimized and the postoperative recovery time was significantly shortened. A 72-year-old uncle Sun went to Huashan Hospital for treatment of a hernia. After considering the patient’s physical condition, Professor Yao Qiyuan of the Department of Surgery decided to use a single-port laparoscopic technique to complete the surgery. Professor Yao first inserted the laparoscope through the patient’s belly button, and while the image was displayed through the mirror, the hernia repair was also done under the mirror, and the whole operation took a short time with minimal bleeding for the patient.