Three months ago Xiao Tan was happy to have a son, the family was overjoyed. But yesterday, Tan suddenly found that her son’s scrotum had become larger when he cried, but returned to normal after he fell asleep. The situation remained the same for the next few days. He went to the hospital and was diagnosed with a hernia. After consulting a number of hospitals, some doctors said that he would be fine when he grew up and not to have surgery, while others said that he should have surgery as early as possible …… Xiao Tan’s family became more puzzled. The hernia (commonly known as “small intestine gas”) is mostly seen in children and middle-aged and elderly people. For children, some parents believe that surgery is not advisable and that they should wait until they grow up or that it may heal on its own; other parents believe that surgical anesthesia will affect the child’s intelligence and are unwilling to let the child have surgery… …In fact, these concepts are incorrect. A hernia is when an organ or tissue in the abdominal cavity leaves its original site and enters another part of the body through a normal or abnormal weak point as well as a defect or a hole. It is like a shoe with a hole in it and the toe is exposed. The sock is called a “hernia sac” and the hole in the shoe is called a “hernia ring”. The most common type of hernia is in the inguinal region, which accounts for 95% of all hernias and is medically known as an inguinal hernia, which includes hiatal, ventral and femoral hernias. Decreased strength of the abdominal wall and increased intra-abdominal pressure are the causes of hernias. Children have a high incidence of hernia due to short inguinal canal, underdeveloped abdominal wall muscles, and congenital developmental problems. In the elderly, the abdominal wall muscles degenerate and lose strength, and some of them are often accompanied by long-term chronic coughing, difficulty in urination and straining to defecate, resulting in increased intra-abdominal pressure, which leads to the displacement of intra-abdominal organs to the weak area of the abdominal wall, so elderly patients also become a high-risk group. If left untreated, hernia can be harmful to the body. In mild cases, it causes local swelling and pain and affects the quality of life; in severe cases, when the small intestine protrudes from the hernia ring and gets stuck and cannot return to the abdominal cavity, it may be accompanied by severe abdominal pain, nausea, vomiting, constipation and abdominal distension; if not treated in time, the protruding small intestine will get tighter and tighter due to swelling and eventually necrosis will occur due to ischemia; in some cases, it will cause sepsis, which is life-threatening. The only way to cure hernia and prevent the occurrence of incarcerated hernia is surgery. When to operate? If the hernia often protrudes but disappears on its own when lying down, the patient can be well prepared (e.g., control chronic cough, relieve constipation) before surgery. Once a protruding hernia is found to be irreversible and accompanied by increased pain, a manual repositioning should be performed immediately after 3 to 6 hours. The method is to have the patient lie flat and quietly, and the repositioner uses the five fingers of the right hand to simultaneously squeeze the hernia sac (inside the scrotum) in an outward direction for 3 to 5 minutes, and the contents of the hernia will mostly be squeezed into the abdominal cavity. However, if the hernia sac does not shrink during the resetting process or if the child cries a lot, he/she should go to the hospital in time to avoid the occurrence of intestinal necrosis. Since the inguinal canal is not atretic until 6 months after birth, it is possible for children within 6 months of age to heal themselves. after 6 to 8 months of age, the muscles of the inguinal region and lower abdomen have thickened and the inguinal canal has become longer. if the hernia still recurs and tends to increase in size, there is no possibility of self-healing. Surgical approach In children, only a high hernia sac ligation is required, whereas in adults, an additional inguinal canal repair is required. Tension-free hernia repair is currently advocated. The principle is to strengthen the weak area of the inguinal canal with a biological patch. Figuratively speaking, it used to be that the hole was sewn up, whereas now it is reinforced with a patch, with the latter obviously being more logical. In addition, a major advance in the current surgical approach is the laparoscopic inguinal canal repair approach. This procedure is the application of modern laparoscopic techniques to the treatment of hernias. If we use the analogy of “mending a shoe”, the previous approach was to fix the patch on the outside of the hole, whereas laparoscopic surgery is to fix the hole from the inside with a patch, thus making the repair more secure and less likely to recur. This approach is suitable for all types of inguinal hernias, especially bilateral hernias and recurrent hernias. It has the advantages of small incision, mild pain, low recurrence rate and fast recovery, but the cost is higher than traditional surgery and requires a higher level of operation of the surgeon. Warm tip: You should go to a regular hospital in time to see a doctor when you have a hernia. Don’t believe the hernia advertisements flying around, such as “no medicine and no surgery for hernia”. In fact, the methods they use are wearing a hernia belt or injection therapy, which cannot cure the hernia: wearing a hernia belt, too loose to work, too tight will compress the vas deferens and affect the testicular development; and injection therapy, most of the injections are sclerosing agents, which can easily prompt local inflammation, and what’s more, once the injections flow into the intestines, they not only fail to play a therapeutic role, but may also make the intestines stick together.