Can a hernia be cured by other means without surgery? Overseas, surgery is almost the only option for hernia treatment. In China there is a lot of publicity about other methods. Many patients also take some non-surgical methods for hernia treatment. However, from a modern surgical point of view, since hernia is a weakness, defect or hole in the body’s tissues, surgery is the only effective way to repair it. What are the surgical options for hernia repair? Surgical treatment of hernias can be categorized into three main types. The first type of repair involves either suturing the edges of the damaged tissue directly, or suturing the upper layers of the damaged tissue in an attempt to cover the damage. This type of repair is often referred to as a tension repair or traditional surgery. Tension surgery is like sewing up a hole in a shirt with thread. This simple suture creates tension at the point of closure, which can lead to pain and recurrence after surgery. Domestic and international data show that the recurrence rate of tension surgery is more than 10%. This type of surgery is more suitable for pediatric and younger patients. The second type is the laparoscopic surgical method. The surgeon inserts different surgical instruments into the patient’s abdominal cavity, and with the help of a camera, a patch is placed into the patient’s abdominal cavity or preperitoneal space. The surgeon performs the surgery through imaging on a television screen. This type of surgery has shown good results in the recent past, but it requires a high level of skill on the part of the surgeon, requires general anesthesia, and is more expensive. This type of surgery is more suitable for patients with bilateral and recurrent hernias. The third category is tension-free hernia repair or tension-free hernioplasty. Tension-free hernia repair was invented in 1984 by Dr. Lichtenstein and his associates at the Lichtenstein Hernia Center in the United States. The method involves covering the hernia defect with a mesh patch that is highly compatible with human tissue. The logic of this method is equivalent to patching a hole in a silk dress with silk. This method is named Lichtenstein’s surgical approach. The method was rapidly adopted by doctors all over the world because of its low recurrence rate, fewer complications, the use of local anesthesia, no hospitalization of the patient after the surgery, quicker postoperative recovery, and lower cost. Today, the Lichtenstein Tension-Free Hernia Repair is not only widely accepted by physicians around the world, but is also honored by the American College of Physicians as the gold standard in hernia repair surgery. The center’s current director, Dr. Amid, is the president of the American Hernia Society. Since the invention of tension-free hernia repair at the Lichtenstein Hernia Center, there has been a proliferation of methods of hernia repair using a variety of materials. These methods are supported by different theories. But basically they all differ in the shape of the repair material. To date, none of the other methods have strongly demonstrated themselves to be superior to the Lichtenstein method in terms of overall results, and the Lichtenstein procedure remains the most commonly used worldwide. What are the complications after tension-free hernia repair surgery? Complications after hernia repair surgery are generally rare. Wound hematomas and superficial wound infections are the most common problems, and these can usually be resolved with conservative measures. More serious problems such as severe bleeding, osteitis and testicular atrophy occur in less than 1% of cases. Will the hernia recur after surgery? The traditional method of sewing the tissues together creates tension, which tears the tissues along the edges of the stitches and causes the hernia to recur. Therefore, the recurrence rate of traditional surgery is 10-15%. Laparoscopic approach. Depending on the experience and skill level of the surgeon, the recurrence rate of hernia after laparoscopic repair is between 0,5% and 11%. Tension-free approach. According to reports from all over the world, the recurrence rate of tension-free repairs performed by hernia specialists is around 0,1%. Overall, the recurrence rate for tension-free hernia repair is between 0,1 and 4 percent. How long does it take to recover from hernia repair surgery? Pain lasts for several weeks after the traditional method (tension method, where the tissue is just stitched together without a patch). It takes 4 to 6 weeks for the stitched tissue to heal. Tension-free and laparoscopic repairs do not suture the tissue to the tissue, so no tissue healing time is required. The healing process depends only on postoperative discomfort, which is minimal and requires only a few days of moderate analgesic medication. Documented medical records and clinical reports from around the world (USA, UK, Italy, Spain, Australia, France) attest to the fact that patients can go home within a few hours of receiving a patch tension-free hernia repair. Depending on the nature of their work and the extent of their desire, patients can go to work normally within 2 to 10 days after surgery. Why mesh plugs are not suitable for inguinal hernia surgery but should be used for patch repair? Tension-free hernia repairs are available in both mesh plugs and mesh materials. Some people describe a mesh plug repair as being like a cork in a bottle, but an inguinal hernia is a defect that occurs on a flat surface. It is like a hole in silk. Therefore the actual repair of the mesh plug is not very effective because the tissue contact with the mesh plug is only at the edges of the mesh plug. The mesh plug shrinks to 75% of its original volume after a few months of implantation. Similar to corks, if a cork shrinks to 75% of its original volume, will it still fit? So, when the mesh plug shrinks, the hernia repair fails. What’s more: the mesh plug shrinks and hardens, forming a hard foreign body mass in the patient’s body. Both the United States and Europe have reported pain in the inguinal area caused by the hardening of the mesh plug and the formation of a hard mass (6% of mesh plugs are removed after mesh plug repair for this reason) In addition, the mesh plugs can migrate into the scrotum and poke through the bladder or the small bowel, which can have serious consequences. History of Hernia Surgery and the Gold Standard for Tension-Free Hernia Repair Around 4000 B.C., doctors were aware of herniotomy and began treating hernias surgically In 1887, the Italian physician Dr. Bassini reported on 38 operations at the Italian Surgical Society in Genoa, establishing himself as the father of the modern hernia repair, and unlike previous hernia surgeries Bassini not only ligated and removed the hernia sac, but also repaired the groin (pulled the internal oblique, transversus abdominis and transversus abdominis fascia together with the oblique aspect of the inguinal ligament and placed the spermatic cord under the tendinous membrane of the external abdominal oblique muscle) Hundreds of hernia repairs have been described from Bassini to the present day In 1959, Ulsher began to use a polypropylene patch for hernia repairs 1984 In 1984, the Lichtenstein Hernia Center in Los Angeles, CA, USA, began routinely using polypropylene for hernia repair and described this method as Lichtensteintension-free hernioplasty, which became popular worldwide in 1996, and was recognized as the gold standard for tension-free hernia repair by the American College of Surgeons in 2000. In April 2004, a U.S. government-funded research project involving more than 400 physicians in the U.S. confirmed that the Lichtenstein hernioplasty is “superior to laparoscopic surgery”.