Daytime tension-free inguinal hernia repair under local anesthesia A hernia is a weak or cracked area in the abdominal muscles of the human body that causes body organs such as fatty tissues or intestines to protrude outward through the area, forming a visible protrusion under the skin, and the pressure generated by the penetration of tissues into the weakened area can cause discomfort and immense pain to the body. The pressure generated by the weak zone of tissue penetration can cause discomfort and great pain, especially when pressure is applied to the area, such as standing for long periods of time, urinating or defecating, or lifting heavy objects. A hernia that flattens out when you lie down or squeeze the subcutaneous protrusion is an eliminable hernia and is not immediately dangerous, but still needs to be evaluated by a doctor: a hernia that is not eliminable is a hernia that does not flatten out if the protruding portion of tissue is severely protruding and does not flatten out; this hernia is usually associated with pain, and immediate action is needed. Bleeding, fever, constipation, severe pain, vomiting and even shock. In the event of these emergencies, surgery must be performed immediately to remove the obstruction and repair the hernia. It is important to seek medical attention even if you only suspect a hernia to avoid serious complications. Extra-abdominal hernias include inguinal hernias, femoral hernias, incisional hernias, umbilical hernias, hiatal hernias, white line hernias, pelvic floor hernias, etc., but the most common is the inguinal hernia commonly known as “small bowel hernia”. Adult inguinal hernias cannot be treated on their own, and surgery is the only reliable treatment for adult inguinal hernias. “Hernias do not discriminate between men and women, and can occur in both sexes. However, inguinal hernias are more common in men, while femoral, umbilical, and incisional hernias are more common in women and are treated in the same way as in men. What is an inguinal hernia? An inguinal hernia is a hernia in which the contents of the abdominal cavity (most commonly the small intestine) protrude through a weak area of the abdominal wall in the inguinal region (thigh root) to form a reducible or non-reversible mass. A reproducible inguinal hernia is a mass in the inguinal region when the patient is upright or when the abdominal pressure is increased, but the mass disappears when the patient is lying down. Why do people develop inguinal hernia? On the one hand, human anatomical and physiological factors, i.e., congenital factors, and on the other hand, acquired predisposing factors. Innate factors such as the inguinal area itself is weak, but also blood vessels and spermatic cord (female round ligament) through the inguinal area after the human body upright pressure increased by three times; acquired triggers include a variety of factors that cause elevated abdominal pressure such as coughing and wheezing, constipation, prostatic hyperplasia and hypertrophy urinary difficulties, heavy labor, pregnancy, cirrhosis ascites and so on. Other factors such as smoking, heredity and so on. What should I do if I have an inguinal hernia? Inguinal hernia in adults is not self-healing. Surgery is the only reliable way to treat inguinal hernia in adults. Early treatment gives better results with fewer complications. How many types of surgery are there? Traditional surgery emphasizes on “sewing”, just like when the pocket of underwear is torn, the hole is sewn directly with a thick silk thread, while tension-free hernia repair emphasizes on “patching”, that is, using all kinds of patches to patch up the holes. What are the advantages and methods of modern surgery? Modern surgery is tension-free hernia repair, is the use of repair material (patch) to repair the hole, which is characterized by tension-free, small incision, less trauma, light pain, fast recovery, local anesthesia can be completed in the outpatient clinic, before and after the operation, no fasting, less fluids, the bottom of the complications, no need to stay in bed after the operation and accompanied by hospitalization, can not be hospitalized, the recurrence rate is low, the domestic and foreign literature reports that hernia specialist surgery is significantly better than the general surgeon. The domestic and foreign literature reports that hernia specialists have significantly better surgical results than general surgeons. How about the advantages and effects of local anesthesia? Most of the domestic inguinal hernia surgery using combined anesthesia or general anesthesia, preoperative and postoperative fasting, postoperative bedridden, infusion of fluids, severe postoperative pain, increased chances of systemic complications, hospitalization time is long and costly. Many patients in the past due to the inability to tolerate half or general anesthesia and can not operate, and ultimately lost the opportunity for treatment, or even life-threatening. Local anesthesia is local nerve block anesthesia, i.e. injection of high concentration of anesthetic for local nerves, less anesthetic dosage, good effect, less pain after surgery compared with other surgeries under anesthesia, no need for painkillers after surgery. No painkillers are needed after the operation. Normal diet and no urinary catheter are used before and after the operation. Inguinal hernia surgery under local nerve block anesthesia expands the indications for surgery, is economical, does not require fasting and water before and after surgery, does not require removal of stitches, does not require a urinary catheter, requires less physical condition of the patient, and is suitable for elderly and frail patients who have a combination of other medical diseases. What is the material of the patch used for tension-free hernia repair? The most used materials in China are polypropylene and expanded polytetrafluoroethylene, which have been used for decades abroad and for more than 10 years in China. The patches are inert materials with good fusion with the surrounding tissues and are free from toxic side effects. Day surgery Day surgery, i.e. local anesthesia surgical services for patients admitted, operated and discharged on the same day, makes the whole treatment process fast and safe. The advantages are: patients can go home early after the operation to reduce the occurrence of postoperative infections, in a familiar environment to recuperate their bodies, can quickly get out of the “patient role”, convenient for the family to take care of, and help to return to normal life and work as soon as possible to minimize the cost of medical care. Usually, tension-free hernia repair surgery is very quick and can be completed in about an hour. Most patients can be discharged from the hospital within 2 hours if there are no problems, depending on the hospital’s specific rules.