Ventral hernia, commonly known as “hernia” and “small intestine pneumonia”, is one of the most common clinical conditions in general surgery. What is an extra-abdominal hernia? The most classic analogy is that the outer tire of a car tire has a hole and the inner tire has a bulge. Why do you get an extra-abdominal hernia 1, the strength of the abdominal wall is reduced: such as certain tissues through the abdominal wall of the site; poor healing of surgical incisions, trauma, infection, old age, etc.. 2, increased intra-abdominal pressure: such as chronic cough, chronic constipation, difficulty in urination, pregnancy, weight lifting, infants often cry, etc. What are the common extra-abdominal hernias? Here are a few easily breached defenses: 1. internal inguinal canal (internal ring): the spermatic cord in men and the round ligament of the uterus in women penetrate the abdominal cavity from here, and the inguinal canal is a potential orifice from which inguinal hernia protrudes; 2. triangle of direct hernia: the triangle enclosed by the outer edge of the rectus abdominis muscle, the blood vessels under the abdominal wall and the inguinal ligament, this area is not covered by the abdominal muscle, and the transversalis abdominis fascia here is also weaker in elderly patients. 3. femoral canal: below the inguinal ligament, there is a potential gap on the medial side of the femoral vein called the femoral canal, where femoral hernias tend to protrude; what is an incarcerated hernia? Sometimes the hernia ring is small and the hernia sac is large, and when the abdominal pressure suddenly increases, the hernia contents forcefully expand the hernia ring and slide into the hernia sac, after which the hernia ring retracts and the contents become stuck and cannot be retracted, which is called an incarcerated hernia. If the incarcerated hernia is not released, the obstruction of blood flow of the stuck intestine leads to necrosis of the intestine, which is called strangulated hernia. Therefore, emergency surgery is needed if the ingrown hernia cannot be retracted, and even if the ingrown hernia has been repositioned manually for a long time, it is still necessary to stay in the hospital for observation (at least 24h) to exclude the possibility of intestinal necrosis. How is a hernia treated? Since hernias are caused by defects in the abdominal wall, there are no medications available for the treatment of ventral hernias other than surgical repair. How to choose the procedure? Some strangulated hernias combined with severe infection may cause repair failure, so they can also be temporarily ligated and repaired surgically in the second stage. In addition to the above, hernia repair is usually required. Tension-free repair of inguinal hernia Let’s say that a large hole is broken in a dress and it may be wrinkled when sewn up directly, then a patch is put on the hole to keep the broken area flat, and this patch is a hernia patch. Currently, the following types are commonly used: 1. filled tension-free repair: the badminton-like cone is the filled hernia patch, commonly known as “mesh plug”, which after surgery turns the part of the hernia ring that was the lowest point of peritoneal stress into the highest point instead, preventing the hernia from protruding from here again and reducing the chance of recurrence. 2.Pre-peritoneal tension-free repair: This method is more demanding than the filling method and requires high freeing of the hernia sac up to the pre-peritoneal hiatus. This is the most commonly used open tension-free hernia repair at present. 3.Laparoscopic hernia repair: With the increasing improvement of minimally invasive technology, laparoscopic hernia repair is becoming more and more widely performed and mature. Compared with open surgery, laparoscopic surgery starts from the posterior side of the hernia, i.e. the starting point of the hernia protrusion, so that the hernia protrusion can be observed more directly and the patch placed can be larger and flatter, which is currently a recommended surgical method. If the patient cannot tolerate surgery, the hernia ring can be blocked with an external hernia belt to prevent the hernia from protruding and expanding further;