During the embryonic period, there is a “peritoneal sheath” in the groin that helps to fix the testis descending into the scrotum or the round ligament of the uterus. The incidence of hernia is generally 1-4%, 10 times higher in boys than in girls, and even higher in preterm infants, with the right side being more common and possibly both sides. Symptoms of pediatric hernia 1. Usually, when a child cries, exercises vigorously, or has dry stools, there is a raised mass in the groin, sometimes extending to the scrotum or labia; it disappears on its own when lying down or when pressed by hand. 2. Once the hernia mass becomes ingrown (the hernia mass cannot be retracted), abdominal pain and crying will occur, followed by vomiting, abdominal distension, fever, irritability, and then dehydration and shock. The danger of pediatric hernia Pediatric hernia first affects the patient’s digestive system, and because the groin is adjacent to the genitourinary system, the normal development of the reproductive system can be affected by the extrusion of the hernia. In addition, the intestinal canal, ovary, fallopian tube and large omentum inside the hernia sac are prone to inflammatory swelling caused by extrusion or collision, resulting in difficulty in hernia retraction and causing serious complications such as abdominal pain and even intestinal obstruction, intestinal necrosis, ovarian and fallopian tube necrosis, which may be life-threatening if not treated in time. Therefore, pediatric hernia should be treated early and thoroughly. When to operate Foreign opinion is that surgery within one month after the diagnosis of hiatal hernia can avoid more than 90% of the complications caused by hiatal hernia, that is to say, surgery can be performed at 2-3 months of life. 2.Surgical methods There are minimally invasive and traditional surgical methods, the following is a brief introduction to the advantages and disadvantages of both. (1) Traditional surgery: no need to enter the abdominal cavity, lower cost, my surgical incision is generally 1.5-2 cm, but after surgery, some children have heavy local edema and hematoma, and cannot detect whether there is a hiatal hernia on the opposite side. (2) Minimally invasive laparoscopic surgery: compared with traditional surgery, laparoscopic surgery ensures the physiological integrity of the inguinal canal and avoids its dissection, which also avoids intraoperative damage to the spermatic cord, vas deferens and bladder and scrotal hematoma, while laparoscopic surgery clearly exposes the inguinal canal in the abdominal cavity and can achieve high ligation of the hernia sac in the true sense, with a small incision (only 0.5 cm), short operation time and quick postoperative recovery (more so in older children). The incision is small (only 0 cm), the operation time is short, the postoperative recovery is fast (more obvious in older children), and the contralateral occult hernia can be detected and treated at the same time. The advantages of laparoscopic surgery are particularly evident in cases of recurrence after conventional surgery. There is no significant difference in the recurrence rate after the two procedures. How to choose? In my personal opinion, I recommend girls to choose the minimally invasive surgical approach because, after all, girls have relatively higher aesthetic requirements and the postoperative scar is located at the umbilicus, which is small and hidden. According to statistics, the chance of left-sided hernia appearing late in the first stage of right-sided hernia is lower, while the chance of right-sided hernia appearing late in the first stage of left-sided hernia is higher, so minimally invasive laparoscopy is preferred for left-sided hernia.