Hernia knowledge 1, what is a hernia “Hernia” is the body’s normal tissues or organs through the potential cavity or weak area, from the original site to other parts of the displacement. Of the various types of hernias, inguinal hernias, commonly known as “small bowel gas”, account for almost 95%. There are also incisional hernias, umbilical hernias, pelvic floor hernias, diaphragmatic hernias, and parastomal hernias. Inguinal hernia (commonly known as small intestinal gas) is a common and frequent disease in middle-aged and elderly people, children also often occur, refers to the abdominal cavity organs through the inguinal area of the weak area protrudes into the skin to form a mass, middle-aged and elderly men account for the vast majority. 2, hernia bring us what is the harm? The early stage of extra-abdominal hernia is generally manifested in the corresponding area of the localized mass, most people do not pay much attention to, think it does not matter. But with the prolongation of time, the swelling is getting bigger and bigger, seriously affecting daily activities and sports. At the same time, there are different degrees of pain sensation, so that the quality of life is greatly reduced. More serious is when the hernia out of the contents of the intestinal tube such as intussusception may cause intestinal obstruction leading to intestinal necrosis or even life-threatening. Surgeons remind: hernia should be treated as soon as possible after surgery, the longer the delay, the greater the difficulty of treatment. 3, the treatment of hernia must be operated? It can be said with certainty that so far surgery is the only way to treat hernia fundamentally. There are three reasons: 1, the general use of conservative treatment, including hernia tray, hernia belt, Chinese medicine therapy can only temporarily relieve the symptoms, can not play a role in the root cause. 2, the surgery to the patient’s pain and recurrence of the problem of postoperative surgery with the progress of modern medicine to get the fundamental improvement, surgical trauma is very small, after the operation of the recurrence rate is very low. 3, the inguinal hernia of the adult has no self-repair possibility, only through the surgery to target the cause of the hernia, the surgery can only be used to repair. The surgery can only be performed by repairing the cause of the disease and achieving the root cause of the disease. 4, hernia surgery methods and indications l hernia sac high ligation: applicable to pediatric hernia l traditional tension repair: due to the high recurrence rate and greater pain, is now rarely used. However, it is still used in some areas of China. l Modern individualized tension-free repair: today’s mainstream surgical methods, coupled with advances in anesthesia and improved surgical techniques, has a very low recurrence rate and very small surgical trauma. However, it is not easy to achieve standardized individualized tension-free repair. l Laparoscopic repair: for some inguinal hernias and most incisional hernias, parastomal hernias, esophageal hiatal hernias, etc., it is a minimally invasive treatment method with great prospects for development. Currently the price is on the expensive side. 5, the correct choice of hernia treatment method Many patients, including some medical workers, in the past often hernia surgery as a general minor surgery and random. But with the progress of modern anatomy and surgical technology and material science, this surgery has undergone a fundamental change. The current status of hernia surgery at home and abroad has proved that there is no specialized training, the effect of treatment is very different, so we advocate hernia surgery specialization. Without specialization and individualized treatment, we will not achieve good results, which is one of the reasons why many patients do not go for treatment due to the fear of trauma and recurrence. Why do we have hernias? – Why do we have hernias? –Why do we have hernias? – Knowledge about hernias – Knowledge about hernias Humans are the only mammals to walk upright for long periods of time, and walking upright and working is a significant difference between humans and animals. But walking upright has also brought us human beings its unique diseases: hernia, hemorrhoids, varicose veins of the lower extremities and lumbar disc herniation. These four diseases are unique to humans. What is the reason for this? The reason is very simple: walking upright inevitably leads to a shift in the center of gravity of the human body, and the low-hanging parts of the body are subjected to increased pressure, which leads to the occurrence of the above-mentioned diseases. Hernia is one of them. What is a hernia? Any organ or tissue that leaves its original location and enters another part of the body through a normal or abnormal weak point or defect or hole is called a hernia. In Chinese medicine, this is called a “hernia” or “small bowel hernia”. The most common type of hernia is an extra-abdominal hernia, 95% of which are inguinal hernias, which are one of the most common surgical conditions. The general incidence of hernias is 1-4%, 15 times higher in men than in women. What can cause a hernia? As mentioned earlier from an evolutionary point of view, walking upright inevitably leads to an upward shift of the body’s center of gravity and an increase in pressure on the lowest part of the body (the abdominal cavity). This is an extrinsic factor in the formation of hernias, and the other side is intrinsic: the strength of the abdominal wall and holes. In the elderly, the strength of the abdominal wall muscles and tendons decreases as they degenerate, and in men, the testicles descend from the abdominal cavity to the scrotum during embryonic life, leaving a hole, which is why children, the elderly, and male patients are more prone to hernias. The above theory for the following analogy may help good understanding: our abdominal wall is like a barrel, the peritoneum is like a balloon, the water inside the balloon is like the abdominal cavity organs, will be filled with water balloon into the barrel, with the hand pressure of the balloon, if there is a hole in the wall of the barrel, imagine what the results will occur? Wouldn’t the water and part of the balloon protrude through the hole, forming a small hemispherical object. This thing is a hernia. So the causes of hernia are two factors: reduced strength of the abdominal wall and increased intra-abdominal pressure. What conditions can lead to increased intra-abdominal pressure? Suffering from chronic bronchitis, prostate hyperplasia and enlargement, habitual constipation; long-term chronic cough, urinary difficulties, defecation effort; cardiopulmonary disease, liver disease caused by ascites; the elderly abdominal wall muscle, tendon degeneration, strength reduction, coupled with obesity or long-term illness bedridden and so on is very easy to lead to the atrophy of abdominal wall muscles and suffer from a hernia; the child because of the crying, spermatic sheaths are not closed, resulting in a congenital hernia or syringomyelia. What are the symptoms of hernia? A hernia can be seen or felt. When you notice a lump appearing at the base of your thigh or near your abdominal area that may disappear when you lie down, can occasionally be painful and uncomfortable, and can be aggravated by exercise, you may have a hernia and should see a doctor as soon as possible. Within a year after the child is born, parents can see or feel the scrotum of these small infants significantly enlarged with a swelling, with a finger to gently pressure the swelling can make it return to the abdominal cavity. This is a baby hernia. What to do if you have a hernia: Hernias are more common in children and the elderly, and are more common in men. The hernia is usually only localized in the lump, occasionally distended, part of the protruding small intestine can not be returned to the abdominal cavity will be necrotic, infection, serious can be combined with toxemia, life-threatening. Therefore, except for a few special circumstances, hernia should be early surgical repair. In infants, the inguinal canal does not become atretic until 6 months after birth, so it is possible for a hernia to heal on its own within 6 months. However, if the hernia does not disappear or tends to increase in size after the age of one year, it is unlikely to heal itself. Therefore, surgery should be considered for hernias in infants over 6 months of age. Is there any way to cure a hernia without surgery? The answer is definitely no. Surgery is the only way to cure a hernia. The reasoning can be drawn from the analogy of the barrel, the balloon and the water. Any use of herbs, sclerotherapy, hernia belts, etc. will not fix the hole in the barrel. The only real solution to a hernia is to repair the hole with surgery. Surgical methods for hernia. Due to the incomplete knowledge of human anatomy of hernia, within a hundred years of the birth of surgery, there are more than 80 surgical methods of hernia, but there are not many that can withstand the test of practice. Recognize the theory of surgical treatment of hernia can also be illustrated by a life analogy: we often wear socks often appear in the big toe hole, big feet often exposed from the hole, how to do? What can we do? What young people do is to sew the holes with thread, but within a few days, the big feet are exposed again, and finally we have to buy new ones. But our mothers would patch up the holes with patches, and they could be worn again for a long time, so the saying goes: three years of sewing and mending. This sewing and patching are the two main types of hernia surgery. Sewing, which is not strong, is prone to recurrence. It is now meeting its fate of obsolescence. Mending, is a good method, but what about the material? Currently all domestic imports of patch, the implanted synthetic material is currently recognized by the World Health Organization is the only biological implant material in line with the eight standards of implant materials. So the current patch material is absolutely safe. This is what we often call tension-free hernia repair. It is similar to the method of patching in life. What should I be aware of before and after tension-free hernia surgery? Most tension-free hernia surgeries can be done under local anesthesia. Therefore, the surgeon will only ask for some regular routine checkups before the surgery. The surgery under local anesthesia does not require water fasting, enema or urinary catheter. Young people without underlying diseases can get out of bed after the operation, but it is recommended to stay in bed for 1-2 days without restricting activities, without removing stitches, and can be discharged from the hospital in 3-4 days after the operation.