Hernia, commonly known as “hernia”, is also called “small intestine gas” by the people. The main cause is a weakness or defect in the abdominal wall, and when the pressure in the abdominal cavity increases, the organs in the abdominal cavity will protrude outward from the weakness or defect, thus forming a hernia. Hernia is a common and frequent disease that occurs in older age groups. According to statistics, the incidence of hernia in people over 60 years of age is as high as 11.8%. As the aging of the society continues to increase, hernia will seriously affect the quality of life of the elderly. The main hazard of hernia is that it can easily cause small intestine impaction and necrosis, therefore, repairing the weak and defective abdominal wall becomes the root of the cure. Hernia repair was carried out by our ancestors more than 100 years ago. However, because traditional inguinal hernia repair involves forcibly pulling together and suturing the adjacent tissue structures, there is a lot of tension and a high incidence of long-term postoperative pain. Especially for people with weak tissues, such as the elderly, the biggest disadvantage of this procedure is that it “tears down the east wall and mends the west wall” and has a high recurrence rate after surgery. Tension-free hernia repair has been gradually introduced at home and abroad in the past 20 years, using artificial materials (patch) to repair abdominal wall defects, which has reduced the recurrence rate after surgery. However, this procedure is highly invasive and the problem of pain remains unresolved, while some patients experience a significant foreign body sensation. Therefore, the preperitoneal repair method has emerged again, allowing larger patches to be placed deeper into the abdominal wall, further reducing the recurrence rate of inguinal hernias and greatly improving postoperative comfort. In recent years, with the rapid development of lumpectomy technology, laparoscopic tension-free hernia repair has emerged, thus completely solving all the drawbacks of the previous surgery. This operation only requires three incisions of 0.5-25px in length on the abdominal wall, and the repair operation can be completed with chopstick-like fine laparoscopic instruments, which has the advantages of less trauma, less pain, faster recovery, shorter hospital stay, no restriction of physical activity after surgery and very low recurrence rate. Pre-peritoneal hernia repair is the leading technology At present, for inguinal hernia repair, the application of patch for pre-peritoneal repair is the leading technology. The advantages of this surgical approach include exact repair of the weak abdominal wall, deeper placement of the patch, less discomfort for the patient, easy operation, and lower recurrence rate after surgery. A 79-year-old uncle Hu, who had a history of hypertension, emphysema and diabetes for many years, had found a right inguinal mass for 8 years and the hernia was increasing in size year by year. At the end of last year, the hernia of Uncle Hu was already bigger than one and a half fists of his own, and often the intestinal tube could not return to the abdominal cavity after the hernia protruded, so he went to the hospital several times for emergency manual reset, but it was good that no intestinal necrosis occurred. But because of the severity of the abdominal wall defect, coupled with years of lung disease and diabetes, the risk of surgery was too great, and several hospitals declined Hu’s request for surgery. On March 12 of this year, Dr. Hu was sent to the hospital for general surgery due to an incarcerated hernia. After an emergency reset, the doctor conducted a thorough examination and evaluation of Dr. Hu and decided to take the risk of performing a hernia repair. On the fourth day of hospitalization, after the underlying disease was under control, the surgeon used the preperitoneal repair method and skillfully used the hernia patch to successfully repair the severely defective abdominal wall of Uncle Hu. After the operation, Uncle Hu did not develop incisional infection and foreign body sensation in the lower abdomen, and no hernia recurrence has been seen so far. The hernia began with a feeling of swelling in the right groin, but later the hernia mass prolapsed into the scrotum and the swelling became heavier and heavier, and slowly the protrusion reached the size of a fist, causing pain after standing for a while. He had a history of hypertension and coronary heart disease for many years, and after activity, he would have panic attacks and chest tightness, so he had to take a large amount of medicine every meal and keep quick-acting heart pills in his pocket for a long time. After the hernia symptoms aggravated, Luo DaBu hope to be surgical treatment, had to go to a number of hospitals for examination, doctors are of the opinion that Luo DaBu heart problems are serious, the usual heart rate is only about 50 times / min, also multiple infarct foci in the brain, anesthesia risk is great, plus Luo DaBu abdominal wall defect is too large, prostate hyperplasia is serious, easy to recur after surgery, surgery is not recommended. On July 4, Luo was sent to the hospital by his family. The doctor evaluated Luo’s cardiovascular and cerebrovascular system disease and concluded that although the risk was high, there was still a chance for surgery. Considering the high impact of general or hemi-anesthesia on the body and the need to install a pacemaker, it was decided to perform hernia repair surgery under local anesthesia. On the third day after hospitalization, Dr. Luo was under close clinical care and under local anesthesia, a patch was used to perform an anterior peritoneal hernia repair, and he was talked to while operating. The operation progressed smoothly and Luo was discharged from the hospital soon after the operation. Director Xie Song said: There are various surgical and anesthetic methods for inguinal hernia in adults, which need to be selected according to the patient’s age, health status, nature of practice and the specific situation of the hernia. Usually, for patients with sound heart and lung function, the most advanced preperitoneal hernia repair and laparoscopic hernia repair can be chosen; while for elderly patients or patients with combined heart, lung and other vital organ diseases who have difficulty tolerating conventional anesthesia, preperitoneal hernia repair under local anesthesia can also be considered, but the surgical accuracy and surgical proficiency of the surgeon in charge are extremely demanding. In clinical practice, about 10-20% of patients with hernia also have contralateral “occult” hernia, which means that the abdominal wall defect may exist in the inguinal region bilaterally and the weaker side is the first to protrude, and after surgery to repair this side, the contralateral weak point will be “original” after surgery. The weaker side is the first to protrude, and after surgery, the contralateral weak point is “revealed” and the hernia reappears. Since laparoscopic hernia repair is both therapeutic and observational, the recurrence rate of hernia after surgery is very low because the weak area on the opposite side can be detected intraoperatively. On March 18, 57-year-old Mr. Yi had his left inguinal hernia surgery at an outside hospital. After the surgery, he was mentally and physically exhausted by incisional inflammation, scar pain and repeated drug changes, which made him travel back and forth. The incision healed after more than a month and he thought he could rest easy, but unfortunately, two months after the operation, not only the pain and discomfort in the left groin still existed, but the right side also had a hernia. On July 14, Mr. Yi was referred to Director Xie Song for treatment. After examination, it was found that the right inguinal hernia was very clear and the surgical scar in the left inguinal area had formed and was more serious, and the pain and discomfort was not necessarily a recurrence of the hernia. Director Xie decided to perform laparoscopic hernia repair considering that laparoscopic repair of the right hernia could reduce trauma and recurrence rate, and intraoperative lumpectomy could clarify whether the left hernia recurred, and if it did, repair surgery could be performed at the same time. After Mr. Yi was hospitalized, Director Xie Song performed a tension-free hernia repair for his inguinal hernia laparoscopically, and intraoperative observation of the left groin confirmed that the left hernia did not recur. After the operation, Mr. Yi felt very little pain in the incision, started to get out of bed the next day, and was discharged on the third day. When he was discharged from the hospital, Mr. Yi lamented, “If I had taken laparoscopic surgery the first time, the wound would not have been inflamed and I would not have had to have a second surgery. If the second surgery was done in that hospital, the original surgical scar would have been innocently cut again, and that would have been for nothing, with unimaginable consequences.” The 33-year-old Ms. Yang found a walnut-sized mass in the oblique area of the left groin for eight years, protruding after each movement, lying down and gone. For many years, Ms. Yang did not take it seriously, but at the beginning of this year, she found that the protrusion had become slightly larger, so she went to the hospital for examination, and the doctor thought it was a “hernia”, which was confirmed by ultrasound examination of the left side of the hernia, and surgery was recommended. On July 28, Ms. Yang went through the hospitalization procedure. Considering Ms. Yang’s young age, the need to take into account the aesthetic effect of the surgery, and Ms. Yang’s own request for minimally invasive surgery, Director Xie Song made three incisions of 0.5-25px in size in Ms. Yang’s abdomen and first explored with the laparoscopic lens, and found that in addition to the left inguinal hernia, there was also a significant hernia protruding from the right side, so the hernia was repaired simultaneously in the surgery. Both hernias were repaired at the same time. One week after the surgery, Ms. Yang, who had recovered well, went to the hospital for a review and the three surgical incisions on her belly were almost invisible. When she saw Director Xie, Ms. Yang said happily, “I am very lucky that I had a minimally invasive surgery, otherwise I would have had to have a second surgery.” Director Xie Song said: The advantages of laparoscopic hernia repair are not only the small trauma, fast recovery, beautiful incision and very low recurrence rate, but also the timely detection of the contralateral occult hernia and the repair of both sides of the hernia at the same time in one operation without additional trauma to avoid the recurrence of the hernia after surgery. In Ms. Yang’s case, if the repair was performed by conventional surgery, the hernia on the right side would be difficult to detect and would soon require a second surgery, as in the case of Mr. Yi. Therefore, laparoscopic hernia repair is more likely to reduce the recurrence rate of postoperative hernia.