Patient Question:Disease:Small intestinal herniaDescription:My daughter is now 5 years old and 4 months old. She was found to have a left inguinal hernia that is retractable six months ago and has been hesitant whether it is better to do traditional or laparoscopic. Hope to provide help:Recently I saw that your hospital has single-hole laparoscopy, and I looked it up on the Internet. It is treated by single-hole laparoscopic pediatric hernia sac high ligation through the umbilicus, and this is obviously better than the previous 3-hole one. If I have a transumbilical laparoscopy, the scar will be very high, because girls, when they grow up, will they be able to see the scar when they wear low waist pants? Director Liu, please help me choose a suitable surgical plan, which one is better: traditional, multi-hole or single-hole laparoscopy? What kind of anesthesia is used for each, and how long is the hospital stay? I heard that some hospitals are very tight on beds, so I may have to make an appointment for a month or two after seeing them, so we can’t afford to go back and forth. My daughter took her piano exam in mid-August, and I want to go to your hospital in late August after the exam, and I will be in elementary school in September. If so, then I will advance. Response from Liu Sujun, Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital: Hello everyone! With the help of a consultation from a parent of a child and the website platform, I would like to focus on answering and describing the most minimally invasive single-hole laparoscopic technique for the treatment of inguinal hernia in children for your reference. The cause of inguinal hernia in children is different from that in adults, regardless of the age of onset, due to congenital incomplete closure or atresia of the peritoneal sphincter. Therefore, the surgery requires only a high ligation of the hernia sac and does not require the use of a patch. Pediatric laparoscopic high ligation of the hernia sac has unparalleled advantages over traditional surgery because of its minimally invasive nature, short operative time, rapid postoperative recovery, precise efficacy, and the ability to treat bilateral hernias in one visit. Therefore, it has become the preferred procedure for the treatment of hernia in children in recent years. In order to pursue smaller trauma, reduce poking holes, leave no scars and better show the advantages of laparoscopy, single-hole laparoscopic technology has become a popular research in recent years, and has now developed from the traditional 3-hole laparoscopy to 2-hole, and in order not to leave visible scars, in recent years, large hospitals with conditions have started to study single-hole laparoscopic technology, trying to make holes only through the navel. The reason why laparoscopy chooses the belly button for perforation is to use the belly button as a natural scar nest to achieve the effect of concealing the scar. In order to pursue single-hole technology, many hospitals have moved the poke card holes of other parts to the belly button, with or without connection between the poke holes, and the laparoscope and all operating forceps enter the abdominal cavity from the belly button. However, the disadvantages of this are: 1) some scars will still be revealed after the umbilicus is enlarged, which may also cause incisional hernia, 2) the centralized placement of instruments will fight and inconvenience the operation, which will also prolong the operation time, 3) special expensive instruments are needed, and 4) the operation is difficult and not easy to promote. In order to overcome the above disadvantages, we have developed a needle-like thin operating forceps on the 2-hole technique, and the umbilical hole is only placed with the observation mirror, so that single-hole laparoscopic hernia sac ligation can be successfully completed without enlarging the umbilical incision or increasing the poking hole, using needle-like forceps and hernia needle. The advantages of single-port laparoscopy in terms of no scarring, safety and reliability, minimal injury, minimal pain and fastest recovery are fully exploited. The child can eat and get out of bed after waking up from anesthesia, and can go home on the same day after surgery, which is very popular among children and parents. This technique is the first of its kind in China, and it is the most cutting-edge, minimally invasive single-hole laparoscopic technique for treating hernia in children, with minimal trauma and no postoperative scars. This is one of the most frequently asked questions from parents about anesthesia, and I have focused on answering this question in my popular article “Frequently Asked Questions about Children’s Hernia”, which has now received more than 10,000 hits. To repeat, all surgeries in children require general anesthesia, and all minimally invasive surgeries in both adults and children also require general anesthesia, and normal anesthesia has no effect on the brain.