An organ in the body that protrudes through a weak point in the abdominal wall is called a hernia, commonly known as a hernia. It is like a tire, when the outer tire is damaged the inner tire will bulge out from the break. The common ones are inguinal hernia and incisional hernia. Inguinal hernias are congenital in childhood and acquired in adults, with hiatal hernias being the most common. How do I know I have a hernia? When a hernia occurs, you will see a bulging mass on the skin of the abdominal wall. This mass appears when you stand or cough and can disappear when you lie down. The most common type of hiatal hernia has a mass that can go into the scrotum. You may not feel discomfort. However, you may feel pain when you lift heavy objects, cough, urinate or defecate hard, or stand or sit for long periods of time. If the pain is sharp and quick, be sure to pay attention and contact your surgeon immediately. This may be a sign of an ingrown hernia (a stuck intestine or other tissue) or strangulation. What are the causes of hernias? Two types of causes: First, reduced strength of the abdominal wall, such as an abdominal surgical incision is an area prone to hernia because of the weakness of the abdominal wall in such areas. Because the inguinal region of the body is an area of congenital weakness of the abdominal wall, hiatal hernias are most common. Second, increased intra-abdominal pressure, persistent coughing, difficulty urinating or defecating, and frequent straining can increase the risk of hernia. People of any age can have a hernia. Still, the risk of developing a hernia increases with age. What are the treatment options for a hernia? Conservative treatment: Only used for infants under 1 year old and for those who are too old and weak to tolerate surgery. Surgical treatment: There are two types of treatment: traditional repair and patch repair (tension-free). Traditional repair is to use the tissues around the weak area and force sutures. Postoperative symptoms such as local tension and painful discomfort are more common and the recurrence rate is higher, but it saves money. It has now been eliminated by large hernia centers. However, it is still used in primary hospitals in China. Patch repair is the most commonly used method nowadays, and there are many kinds of patches and many procedures. The choice needs to be individualized according to the patient’s specific situation. The most advanced one is laparoscopic hernia repair. What are the advantages of laparoscopic hernia repair? Repairing a hernia with a patch is like patching a broken sack. Of course, the patch is most reliable inside the sack, and laparoscopic surgery allows the patch to be placed at the deepest level (posterior approach), allowing the placement of a patch as large as possible, which naturally results in a low recurrence rate. The worst thing about placing a patch is infection, which once it occurs, requires surgery to remove the patch and then surgery to repair the hernia after the infection has healed. The laparoscopic incision is small and away from the patch, so there is little risk of infection. Laparoscopy allows easy and comprehensive view of both groins from inside the abdominal cavity, enabling timely detection of contralateral occult hernias (about 20%) that are usually missed because of the absence of episodes, so that bilateral hernias can be resolved simultaneously in one operation, avoiding the painful reoperation for contralateral hernias 1 to 2 years after the first operation by traditional surgical methods. Contralateral occult hernia is found to have a higher actual incidence in our laparoscopic surgery, especially in the elderly. The incision is aesthetically pleasing, with only three small incisions (two 0.5 cm, one 1.0 cm, of which the 1 cm is also in the umbilicus), making it the best choice for patients with aesthetic requirements. What are the disadvantages of laparoscopic hernia repair? The technical threshold is high and the learning curve is long. This procedure requires solid lumpectomy skills, knowledge of posterior approach anatomy, and individualized patch cutting ability, which is the reason why it is not easy to promote.