Inguinal hernia can heal spontaneously if the child is under 1 year old, but not if the child is over 1 year old. Children’s hernias require only a high ligation of the hernia sac. Adolescent and adult hernias require a tension-free repair (patch repair), both open and laparoscopic. The choice of surgical procedure and patch is not clear to lay people, and many patients or families often ask this question, so I will give a brief introduction here to give you a preliminary understanding. Before the 1990s, the traditional method of repair was used, using sutures to sew up the hole, because there is tension after the patching, so it is easy to cause long time pain and slow recovery after surgery. The tension-free repair method (patch repair) from the United States was introduced in China 20 years ago and has been used ever since. The patch is used to patch the hole, which is tension-free, easy to operate, short operation time, little trauma, fast recovery and low recurrence rate. There are two types of surgery: open surgery (open incision) and laparoscopic surgery (3 holes), both of which are minimally invasive and involve patch repair of the hernia ring (the portal of the hernia) and weak tissues of the abdominal wall, also called tension-free repair. However, laparoscopic surgery is usually referred to as minimally invasive surgery. Open surgery: Under local anesthesia, a small incision of about 4 cm is made in the inguinal region (inside the root of the thigh, where the hernia exits). Advantages: local anesthesia has little impact on the body, is safe, and has a wide range of indications, especially for the elderly who are sickly, have poor health and cannot tolerate general anesthesia. The operation is performed outside the abdominal cavity, and after the hernia sac is treated, the hole and the defect are filled with a patch. The operation is easy to perform, short (usually about half an hour), less invasive, and less expensive (usually about 4,500 yuan, with only about 1,500 yuan reimbursed by the single patient. Biological patches are not reimbursed). Local anesthesia surgery diet is not restricted, no urinary catheter, no infusion, no postoperative medication, cosmetic suture without stitch removal, and you can go home the same day after surgery. Local anesthesia is less disturbing to the body, so it is suitable for all ages (except children’s hernia), especially for the elderly and sickly patients who cannot tolerate general anesthesia, as well as for teenagers, unmarried and childless people or those who require biological patch repair. Local anesthesia surgery has become our specialty and brand, and we have trained hundreds of doctors in hospitals all over China. There are two types of patches commonly used: polypropylene patches (non-absorbable) and bio patches (biodegradable and absorbable), with prices ranging from 100-3500 RMB per patch for polypropylene patches, 4500-11000 RMB per patch for absorbable bio patches, and 5000-7000 per patch for partially absorbable patches. Adults usually choose polypropylene patches or partially absorbable patches routinely; those over 10 years old, adolescents, unmarried children, those who need to have children again, those who have contaminated surgery (incarcerated hernia, strangulated hernia) and those who are poorly tolerated and prone to infection can choose biological patches for repair. Laparoscopic surgery: There are two types of surgery, TAPP and TEP, which are performed after the establishment of a pneumoperitoneum under general anesthesia. The difference is that three small holes are made longitudinally between the navel and the suprapubic bone, operating in the preperitoneal space without entering the abdominal cavity. The advantages of laparoscopic surgery are: it is a posterior approach, the incision is the same for both fat and thin patients, and the ease of operation is not affected by fatness or thinness. The patch position is deep, with little foreign body sensation and fast recovery. The recurrence rate is relatively low due to the wide range of patch repair. However, due to the large stripping surface, postoperative effusion can easily form for larger hernias. All patches used for laparoscopic surgery are not reimbursed. Both open and laparoscopic surgical methods have roughly the same surgical results, but each has its own advantages and characteristics, and the surgeon will choose different surgical methods and patches according to each individual’s situation and implement individualized treatment. Minimally invasive laparoscopic surgery is preferred for patients with bilateral hernias, obese people, and those with recurrence. Laparoscopic repair is relatively expensive because it requires general anesthesia and laparoscopy, and the total cost of a conventional polypropylene patch is about $10,000 for a unilateral hernia and $15,000 for a bilateral hernia.