There are many ways to repair a hernia, which hernia surgery should I choose? It is a patient’s right to discuss their surgical options with their doctor. Patients should take full advantage of this right. However, each doctor has different habits and specialties, and different doctors do the same hernia surgery differently. A surgeon may also perform a different type of surgery depending on the indication. Therefore, one cannot generalize that one surgical procedure is appropriate for all hernia patients. As mentioned earlier, pediatric and young adult patients may be best suited for traditional tension surgery; bilateral patients or patients with recurrent hernias may be better suited for laparoscopic surgery; and middle-aged and elderly patients may be better suited for tension-free surgery with a patch. Nonetheless, some basic principles apply. As to which type of atotonic surgery to choose you can refer to the introductory section on the various atotonic surgeries? If you choose to use a patch for atony, the basic rule is that the less material that is implanted in the body, the better. The price of the various patch materials varies considerably, but in general, there is no correlation between the price of the material and the outcome of the hernia repair. In other words, the more expensive the material, the better the result. Which type of anesthesia should I choose if I am having tension-free hernia surgery? Hernia repair surgery can be performed under general anesthesia, lumbar anesthesia and local anesthesia. Many studies have shown that 90% of hernia repairs can be performed under local anesthesia with proper preoperative preparation. The advantages of local anesthesia are the short recovery time and the possibility of verifying the results of the surgical repair on the spot. In addition, local anesthesia avoids the disruption of respiratory and immune system function that may result from general anesthesia. This advantage is particularly important for elderly and frail patients. Local anesthesia is not suitable for those patients with excessive anxiety. For such patients, general anesthesia and lumbar anesthesia are more appropriate. General anesthesia is the most comfortable for the patient, however, it is also the most risky (and expensive). Patients are sometimes uncomfortable with general anesthesia and must be hospitalized due to complications such as vomiting, excessive sedation and urinary retention. Lumbar anesthesia provides good analgesia and carries slightly less risk than general anesthesia. Lumbar anesthesia also has its inherent disadvantages. Factors such as taking longer to do lumbar anesthesia, incomplete anesthesia, urinary retention, and slow return of sensation to the lower extremities can all lead to an outcome that necessitates hospitalization for observation. If I decide to have hernia surgery, what hospital and what surgeon should I choose? In China, hernia has long been considered a minor illness. This type of surgery is less common in big hospitals. Not many big-name doctors in big hospitals perform this kind of surgery either. Hernia surgeries in large hospitals are usually performed by less senior doctors. Most hospitals do not have hernia specialists, and patients are operated on by whomever they come to. Hernia surgery is more common in small and medium-sized hospitals, and even in some township hospitals. In this situation, it is difficult to guarantee the quality of hernia surgery. Since there are fewer specialized hospitals and almost no specialized doctors, it is more difficult for patients to choose hospitals and doctors. Generally speaking, hospitals that are too small are best avoided. Doctors who specialize in hernias in large and medium-sized hospitals should be the best choice.