What are inguinal hernias and syringomyelia? Inguinal hernias in children are almost always hiatal hernias and their pathogenesis is due to a congenital factor, the failure of the sphincter to close, but not all open sphincters will develop inguinal hernias. The most common abdominal organ that enters the hernia sac is the small intestine, which is probably the reason why inguinal hernias are commonly known as small bowel gas and hernias, and the ovaries are the most common hernia contents in girls, in addition to the small intestine. Pediatric syringomyelia is caused by incomplete occlusion of the sphincter so that the sphincter canal remains open or partially open. Because of the small diameter of the sphincter, the intestine cannot pass through (when the sphincter is thicker, the intestine can easily pass through then a hernia is formed) and only the abdominal fluid is allowed to flow through the sphincter canal and accumulate in the sphincter cavity, forming a syringomyelia. In female fetuses, the sphincter is called Nück’s canal, and if fluid accumulation occurs, it is called Nück’s cyst. What are the dangers of inguinal hernia and syringomyelia? If the small intestine or ovary is prolapsed for a long time, and the small intestine or ovary is stuck in the area of the ring of the hernia sac and cannot be retracted, it is an inguinal hernia that is ingrown. When the small intestine and ovary enter the hernia sac, the blood circulation to the small intestine and ovary is impaired, resulting in ischemic necrosis of the intestine and ovary, which can cause severe pain and suffering in the child, accompanied by nausea, vomiting, abdominal distention, blood in the stool and fever in severe cases. In addition, in boys with incarcerated hernia, prolonged pressure on the spermatic cord can lead to testicular ischemia and cause testicular infarction. Syringomyelia is not large in size and tension is not high, so it has little effect on the organism, but if the tension is high, it may affect the blood supply to the testes and produce testicular atrophy. How are inguinal hernias and syringomyelia treated? Although the peritoneal syringomyelia can remain occluded after birth, children with hernias are rarely likely to heal on their own. Therefore, all inguinal hernias should be treated surgically after diagnosis to prevent repeated inguinal hernia intussusception, even in preterm infants (especially in those with a history of repeated inguinal hernias and giant hernias, which should be operated early). The treatment is mainly surgical, and hernia belts and anti-injection therapy are not recommended. Surgical treatment of inguinal hernia is already quite safe and can be performed regardless of age. However, since it is an elective surgery, it is appropriate to choose the appropriate period. If the syringomyelia is not large and the tension is not high, there is no urgency to treat it surgically, especially in infants under 1 year of age, as it still has a chance to subside on its own. If the tension is high, it may affect the blood supply to the testes and produce testicular atrophy, and surgery is not limited by age. Should I choose laparoscopic or open surgery? Regardless of the choice, inguinal hernia and syringomyelia surgery are minimally invasive (not “minimally invasive is laparoscopic”, open surgery is also minimally invasive, open surgery incision is very small, about 6-8 mm long), each has its own advantages. For those who suspect the possibility of a contralateral inguinal hernia, the contralateral side can be explored during laparoscopic surgery.