The term “hernia” refers to an inguinal hernia, which is formed when an organ in the abdominal cavity protrudes through a defect in the inguinal region to the surface of the body. There are two types of inguinal hernias: inguinal hernia and inguinal hernia. Inguinal hernias, both congenital and acquired, can enter the scrotum and account for 95% of inguinal hernias. Straight inguinal hernias protrude directly from the inguinal triangle on the medial aspect of the inferior abdominal wall from back to front without going through the internal ring and without entering the scrotum and account for only 5% of inguinal hernias. If left untreated, inguinal hernias are prone to serious complications. The formation of inguinal hernia is due to a decrease in the strength of the abdominal wall muscles and an increase in intra-abdominal pressure. Muscle atrophy in the elderly makes the abdominal wall weak, and the inguinal region is even weaker, with blood vessels, spermatic cords or the round ligament of the uterus passing through it, providing a channel for hernia formation. In addition, many factors that increase abdominal pressure in the elderly (e.g., coughing, constipation, difficulty in urination due to prostate enlargement, etc.) are causative factors for the formation of hernias. Clinical manifestations 1. Repeatable hernia manifests as a repeatable mass in the inguinal region, which is small at first and appears only when the patient stands, works, walks, coughs vigorously, strains to defecate or when the child cries. There is generally no obvious discomfort, and occasionally there is localized distension and involvement pain. As the disease progresses, the mass may gradually increase in size and may descend from the groin to the scrotum or labia majora. The mass is often pear-shaped, narrow at the upper end and wide at the lower end, and can be retracted into the abdominal cavity when lying down or when the mass is gently pushed outward and upward by hand. After the hernia mass is retracted, the fingertip is shown to gently press the inner ring opening, and the fingertip can be touched with the coughing sensation of impact. This method can be used to distinguish hiatal hernia from straight hernia, which can still appear when the patient is asked to cough after the hernia mass is retracted and the finger is pressed against the inner ring opening. Sliding hiatal hernia is a difficult hernia with a large mass that cannot be completely retracted. The contents of the hernia mostly adhere to the anterior wall of the hernia sac, and in addition to incomplete retraction of the mass, there are also symptoms such as indigestion and constipation. The incidence of sliding hernia is mostly seen on the right side, and the ratio of incidence between the left and right sides is about 1:6. During surgical repair, it is important to prevent damage to the cecum or sigmoid colon. Most of them are hiatal hernias, which often occur when the intra-abdominal pressure is suddenly increased (such as violent coughing, forceful stool, etc.). The clinical manifestation is a sudden increase in the size of the hernia mass, accompanied by obvious pain. The mass cannot be retracted by lying down or pushing it by hand, and it is hard and painful to palpation. If the embedded content is the greater omentum, the local pain is often mild and often involving; if it is intestinal collaterals, the local pain is obvious and may also be accompanied by severe abdominal cramps, nausea, vomiting, abdominal distension and other signs of mechanical intestinal obstruction. Once the hernia is embedded, it may become strangulated hernia if not treated timely, leading to ischemic necrosis of intestinal collaterals and even life-threatening. The clinical symptoms of strangulated hernia are more serious. The patient has continuous severe abdominal pain, frequent vomiting, vomiting? The abdomen is asymmetrically distended, with abdominal muscle tension, pressure pain, rebound pain, and diminished or absent bowel sounds; abdominal puncture or lavage is bloody fluid; X-ray examination shows isolated distended intestinal collaterals; it may be accompanied by fever, rapid heart rate, gradual rise in white blood cell count, and even shock. Treatment Treatment of inguinal hernia includes conservative treatment and surgery. Once an inguinal hernia is formed, it can lead to intestinal obstruction, and the progress of the disease can lead to intestinal necrosis, perforation and even death, so it needs to be treated by emergency surgery as soon as possible. Conservative treatment Conservative treatment includes hernia belt, hernia brace, Chinese herbal medicine, etc. These methods can relieve the symptoms or slow down the development of the disease, but cannot cure it, and some improper conservative treatments can aggravate the disease. Conservative treatment is only suitable for infants under 2 years old, the elderly and frail, or those with serious diseases that cannot tolerate surgery. Surgery is the only reliable method to treat inguinal hernia in adults and is less likely to recur. Surgical treatment is divided into traditional hernia repair and tension-free hernia repair techniques, and the best one is currently recognized as the tension-free hernia repair technique, including open surgery and laparoscopic surgery. (1) Traditional surgery Patients need to fast before and after surgery, and be bedridden for several days after surgery. Patients tend to have significant postoperative pain, slow recovery and high recurrence rate, but we generally do not advocate the placement of hernia patches in young patients (under 25 years old) and mostly use traditional repair. Open tension-free hernia repair, which is the most widely used procedure today. The operation can be performed under local anesthesia, has a low recurrence rate, is less painful, generally requires only 2 to 5 days of hospitalization, and can even be completed on an outpatient basis with rapid postoperative recovery. (2) Laparoscopic inguinal hernia repair In recent years, laparoscopic tension-free hernia repair has developed rapidly, which can be performed by covering and fixing an artificial patch to the hernia defect through the abdominal cavity, or by pulling the hernia sac back into the abdominal cavity outside the peritoneum and covering and fixing an artificial patch to the hernia defect. This procedure is suitable for the treatment of bilateral inguinal hernias and recurrent hernias with minimal trauma, rapid recovery and low recurrence rate.