Why should inguinal hernias be treated individually?

  Inguinal hernia is a common surgical condition and hernia suture repair can potentially be as simple as closing the abdomen. Most inguinal hernia surgeries can be performed in 0.5 to 1 hour, and serious complications of surgery are rare. As a result, a significant proportion of inguinal hernia surgeries are performed by young surgeons with little surgical experience, and this phenomenon is prevalent at all levels of hospitals nationwide. The emergence of hernia specialties and hernia specialists has only gradually changed the traditional view of hernia surgery, and the optimization of treatment outcomes has led to the realization that professional training and personal experience are equally important for a “minor surgery” such as a hernia.   Both national and international treatment guidelines recommend only surgical treatment. Inguinal hernia is an absolute indication for surgery, and the key to treatment is knowing when to operate, under what conditions, and which procedure to choose.  Nyhus suggests that hernia treatment should be individualized, with the patient’s duration, age, and history of local surgery being key determinants of the surgical plan. He calls for an adequate preoperative and intraoperative evaluation of the condition, followed by selection of the appropriate procedure. Who are the patients for whom hernia bursa high ligation is indicated? Why do I need a hernia repair? Who needs a patch? The hernia treatment guidelines, based on the concept of hernia staging and the principles of individualized hernia treatment, can give us the answers.  Individualized treatment does not require every surgeon to master a wide range of hernia repair techniques; a surgeon can handle his or her daily work by learning to “give up” a few special cases and truly master two or three hernia repair techniques. For most surgeons, it is more practical and effective to learn one or two inguinal hernia repair techniques in a “few and precise” way than to learn all kinds of tension-free hernia repair techniques in a “big and comprehensive” way. The key is to fully understand the surgical principles and master the surgical operation specifications.  The prerequisite for quality control is the standardization of operating techniques. In order to obtain good results in surgical treatment, it is very important to emphasize the surgical steps and operational details in addition to strictly mastering the surgical indications. The sequence of surgical steps is a summary of many years of clinical experience and is not a matter of random imagination or whim. For example, in a simple case of freeing the spermatic cord and searching for the hernia sac, it may seem that the sequence will not affect the surgical result, but if the spermatic cord is free first, the straight hernia triangle and the inner ring can be clearly seen immediately. This way, one can avoid missing the hernia, and the other can look across the whole picture to see directly where the abnormality is and immediately determine whether it is a hiatal hernia, a straight hernia or a compound hernia. No blind search for the hernia sac will occur, which is conducive to shortening the operation time and avoiding damage to the surrounding tissues Due to the complexity and unknown nature of human functions, medical theory and medical practice are always in the process of exploration, conclusion and gradual advancement. Improvements in surgical techniques can expand the indications for surgery, reduce surgical complications, and improve surgical outcomes. However, the principle of learning new techniques in primary care hospitals should be to try to stay true to the original, and only after accumulating considerable experience and finding that there are indeed recognized problems can improvements be considered. If it is just a personal feeling that there are problems, more consideration should be given to communication and learning.