”The above article describes the surgical options for hernia treatment, but some patients reported that the table is not easy to understand, so we have selected some typical clinical cases for your reference, so that patients with simple conditions can “put them in their place”. Of course, the essence of “private customization” is “completely according to the individual situation”, so we will still determine your “best plan” according to the patient’s specific needs during the consultation and treatment process! Elderly case Old man Wang, male, 77 years old, bilateral inguinal hernia, history of 1 year, healthy, no other chronic diseases except hypertension medication, no history of other chronic diseases, no history of abdominal surgery. Surgical option: laparoscopic bilateral inguinal hernia tension-free repair Reason for selection: bilateral hernia, because open surgery requires one incision on the left and right side bilaterally, while laparoscopy has three holes either unilaterally or bilaterally, so bilateral hernia has the most benefit from laparoscopic surgery. Uncle Li, male, 67 years old, had a right inguinal hernia with a 2-year history, a small hernia mass, a healthy body, a 6-year history of diabetes mellitus, controlled by diet and medication, and no history of abdominal surgery. Surgical option: laparoscopic minimally invasive tension-free repair Reason for selection: the most common clinical situation, old age, good physical condition, not a large hernia; also the patient has diabetes and the small laparoscopic wound can reduce the probability of postoperative infection, so it is very suitable for laparoscopic surgery with fast recovery and light pain after surgery. Master Tian, male, 66 years old, had a left inguinal refractory hernia with a history of 15 years, a large hernia mass that entered the scrotum, and an open surgery for bladder cancer 5 years ago. Surgical option: open inguinal hernia tension-free repair Reason for selection: large medical history, huge refractory hernia, major surgery for bladder cancer in the lower abdomen, both of the above are not suitable for laparoscopic surgery, and open tension-free repair is the most appropriate. Old man Zhao, male, 86 years old, right inguinal hernia, medical history of 2 years, weak, basic self-care, history of coronary heart disease, hypertension, chronic emphysema, hunchback. Surgical plan: open tension-free repair under local anesthesia. Reason for selection: elderly patients with many underlying diseases are not suitable for general anesthesia needed for laparoscopic surgery, and there are also difficulties with hemianesthesia due to hunchback, so only local anesthesia open surgery is suitable, which has little systemic impact on the patient. Summary: Elderly patients are the main group of patients with inguinal hernia. Since elderly people often have other medical diseases at the same time, in addition to the hernia, the patient’s systemic condition should also be considered when choosing surgical options. For patients of advanced age, with more serious systemic diseases, and a history of major lower abdominal surgery, open surgery is chosen, while laparoscopic minimally invasive surgery is preferred for others. For patches the elderly rarely consider childbirth and therefore choose firmer synthetic patches. Young and middle-aged case Mr. Sun, male, 48 years old, right inguinal hernia, 1 year history, plainly fit, no history of abdominal surgery. Surgical plan: laparoscopic minimally invasive tension-free repair with light-weight synthetic patch Reasons for selection: young and strong, short vacation, wishing to return to work as soon as possible, most suitable for laparoscopic minimally invasive surgery; light-weight synthetic patch has good elasticity and less scar formation. Mr. Qian, male, 26 years old, congenital right inguinal hernia, postgraduate student, unmarried and infertile. Surgical plan: laparoscopic minimally invasive tension-free repair with biopatch selection Reason for selection: Young patient, in addition to the surgical plan suitable for laparoscopic minimally invasive surgery, he chose biopatch because he was unmarried and infertile, and he was also worried that the synthetic patch would affect his fertility. (Now that the fertility policy is relaxed, those who already have children but still have fertility requirements can also choose bio-patch) Miss Dong, female, 28 years old, model, left inguinal hernia, history of six months, unmarried and childless. Surgical option: open tension-free repair with a lightweight synthetic patch Reason for selection: For Miss Dong the laparoscopic surgery itself is suitable, but because the laparoscopic surgery hole is in the plane of the umbilicus and because of her occupation, she prefers open surgery where the wound can be covered by her underwear. Summary: Young and middle-aged people are the main body of social activities, busy with work and study and family, and they want to resume their work life as soon as possible after surgery, so laparoscopic minimally invasive surgery is preferred; there are two options for patching, one is a lightweight synthetic patch, which is flexible and has basically no effect on postoperative activities and sports; the other is a biological patch, which is mainly used for those who require fertility later and are worried about the impact of synthetic patching on fertility. Some female patients have dressing and aesthetic requirements and will choose open surgery, which will not affect fertility, so light-weight synthetic patches are sufficient. Infant and adolescent cases Half-year-old boy with congenital right inguinal hernia with small hernia mass Treatment options: Clinical observation Reason for selection: Infants within one year of age still have the possibility of self-healing and can be observed clinically to avoid the occurrence of ingrowth; surgery is considered after two years of age when it still does not heal spontaneously. 8-year-old boy with congenital right inguinal hernia Surgical option: laparoscopic high ligation of the hernia sac Reason for selection: Pediatric hernia requires only high ligation without further repair; the abdominal wall becomes progressively stronger with growth and development into adolescence, so no further repair is needed. Laparoscopic surgery is less invasive and recovery is faster. 15-year-old junior high school student with congenital left inguinal hernia with a large hernia mass into the scrotum Surgical options: open tension-free repair with biopatch Reason for selection: Tensioned repair without patch was previously used mainly for minors under 18 years of age, but the postoperative pain was significant and affected activities and sports. The adolescent stage, although underage, has developed and is physically close to adulthood, and a simple high ligature is also unreliable with a high recurrence rate. In recent years we have begun to experiment with tension-free repair, but because adolescents have not completed their development, synthetic patches cannot be used and only biological patches are an option. Summary: This age group is also a good candidate for inguinal hernia, which is basically congenital. Those under one year of age are mostly chosen for clinical observation, and those that do not heal spontaneously after one to two years of age should undergo high ligation of the hernia sac; the surgical options for congenital hernia in the adolescent stage are still controversial, and we recommend a tension-free repair using a patch, which has both a low impact on postoperative activity and a low recurrence rate.