A hernia is a protrusion of a tissue or organ from a weak part of the body. In early embryonic life, the testis is located behind the peritoneum next to the 2nd to 3rd lumbar vertebrae and gradually descends outside the abdominal cavity, where the descending peritoneum forms a sheath, which atrophies and atresizes shortly after birth, leaving a fibrous cord. If not atretic, a congenital hiatal hernia may be formed. Sometimes, the unclosed sphincter is just a very small duct, which does not appear clinically as a hernia, but only as a syringomyelia. The right testis descends slightly later than the left and the sphincter atresizes later; therefore, right inguinal hernias are more common. Girls have a round ligament of the uterus that descends from the same site outside the pelvis and also forms a peritoneal sphincter, so girls also have hernias. Girls do not have the process of downward migration of the testes and the sphincter closes early, so the incidence is lower in girls than in boys! Generally children with a mass in the groin area should be aware of the possibility of a hernia or syringomyelia. The sphincter can close some time after birth, but once a hernia is formed, it is rarely likely to heal on its own. There is no need to wait for spontaneous healing after a hernia is diagnosed and the opinion of a specialist pediatric surgeon should be sought. Many non-specialists, because their knowledge is not up to date, inform that spontaneous healing is possible within half a year of age is an incorrect opinion! It is important to closely monitor for the occurrence of intussusception while waiting for surgery! If your child’s hernia mass does not disappear even after several hours of prolapse even after being quiet or sleeping, and if he cries a lot or even vomits, you should pay attention to whether the hernia is ingrown. In this case, you should go to the hospital immediately, and you can take an elevated hip position on the way, but it is not recommended to reset the hernia by yourself. Be aware that vomiting may lead to aspiration! Once a pediatric hernia is diagnosed, surgery should be performed promptly to avoid intussusception. There is no age limit for surgery, and I personally recommend that any hernia after birth in March should be treated surgically in the hospital as soon as possible! There are currently two types of surgery, traditional or minimally invasive laparoscopic surgery, with 1-3 nights of hospitalization. Traditional high ligation of the hernia sac is the basic treatment for pediatric inguinal hernia, but the surgery disrupts the anatomy of the inguinal canal and spermatic cord. There is about 10% incidence of scrotal hematoma, and about 0.5-1% of male children are damaged vas deferens or epididymis intraoperatively, and postoperative complications such as testicular atrophy may occur. It is already being phased out! Minimally invasive laparoscopic hernia surgery directly observes the hernia contents without dissecting the inguinal canal and without separating the spermatic cord tissue, thus avoiding the complications of traditional surgery mentioned above. The laparoscope allows intraoperative observation of the closure of the contralateral sphincter (current statistics show that about 30-40% of children have a combination of non-closure of the contralateral sphincter), eliminating the possibility of contralateral hernia in one operation without increasing the surgical incision. The laparoscopic incision is made in the umbilicus without sutures, and experienced surgeons can achieve almost complete concealment of the incision scar in the umbilical fossa. A normal surgery by a highly trained specialist will not affect the child’s future fertility! All surgeries are painful and there is very little pain after minimally invasive surgery. A few children are more sensitive and can have post-operative analgesia. All hernia surgeries have the possibility of recurrence, only the rate of recurrence varies between hospitals and doctors of different skill levels. The recurrence rate after laparoscopic surgery in children’s specialty hospitals is generally controlled to within 1 in 1000! This is a very good result! For a period of time after hernia surgery, strenuous activities such as lifting heavy things, carrying heavy objects, coughing and sneezing should be avoided as much as possible. Young children should try to minimize crying.