I. What is a hernia? What is an inguinal hernia? A hernia is when a part of the body’s tissue or organ leaves its original location and enters another part of the body through a gap, defect or weakness in the body. The symptoms of a hernia are mainly in the inguinal region, so a hernia that occurs in the inguinal region is called an inguinal hernia. How is a hernia formed? Who is prone to hernia? The formation of hernia has a great relationship with the patient’s constitution. It is mostly due to the pressure generated in the abdominal cavity due to coughing, sneezing, overexertion, excessive abdominal fat, forceful defecation, women’s pregnancy, excessive crying of children, degenerative changes in the strength of the abdominal wall in old age, etc., which leads to an increase in the air pressure in the abdominal cavity and forces the free organs in the abdominal cavity such as: small intestine, appendix, large omentum, bladder, etc. to see the holes and pass from their original parts through The normal or abnormal weak points or defects or orifices of the body enter another part of the body. Older men are the most likely group to develop hernias. What are the signs of inguinal hernia? How can I identify myself if I have a hernia? The main symptom of an inguinal hernia is a lump that can be seen or felt in the inguinal region. The most important feature of the lump is that it is recurring, that is to say, it is “sporadic”. The most important feature of a hernia in the elderly is its reversibility, which means that it is “sporadic”. The mass may be seen only in the inguinal region, while in some cases it may reach the scrotum, and a large scrotal hernia may cause mobility problems. The most common cause of the mass is a rise in abdominal pressure, most often due to coughing, difficulty in defecation, and difficulty in urination. The mass is formed by the prolapse of an organ in the abdominal cavity into the hernia pouch. The prolapsed organ is mostly the small intestine, so it feels soft to the touch and is often accompanied by a gurgling murmur when retracted, while other organs such as the large intestine, appendix and large omentum may also prolapse. What are the dangers of inguinal hernia? What should I pay attention to during my daily life? Hernia firstly affects the digestive system of the patient, resulting in lower abdominal cramps and abdominal pain, and in children, the normal development of testicles may be affected by the extrusion of the hernia; as the intestinal canal or omentum inside the hernia sac is easily squeezed or collided to cause inflammatory swelling, the hernia may be difficult to retract, resulting in hernia impaction, as well as intestinal obstruction, intestinal necrosis, severe abdominal pain and other dangerous situations. Patients with hernias should avoid lifting, pushing, or pulling heavy things; give up or minimize smoking, as the smoker’s cough may have an accelerating effect on the development or worsening of the hernia, and giving up smoking may improve the blood and speed up the recovery process; eat less foods that tend to cause constipation and abdominal distention (especially boiled eggs, sweet potatoes, peanuts, beans, beer, carbonated fizzy drinks, etc.) and eat a high-fiber diet, including grains, cereals, bran, and unprocessed foods, Drink at least eight glasses of water a day to help relieve constipation; avoid and reduce sneezing; and breathe deeply to help relieve chronic coughing. V. Can inguinal hernia be cured without surgery? What are the surgical methods for inguinal hernia? Various non-surgical treatments currently in use cannot cure inguinal hernia. Surgery is the only method that can cure inguinal hernia, and at present, the effectiveness of such surgery has been well verified. The post-operative recurrence rate after a regular tension-free hernia repair has been less than 1%. Non-surgical treatment of hernias is slower and has a positive effect on stopping the development of the hernia. Mild hernias can be treated non-operatively on a trial basis. Because the body’s tissues gradually fade with age, it is really difficult to reinforce them by themselves. Adjunctive treatment is available for middle-aged and elderly people. The surgical methods for inguinal hernia include 1) traditional hernia repair; 2) tension-free hernia repair; and 3) laparoscopic hernia repair. Tension-free hernia repair is based on the principle of repairing and strengthening the damaged abdominal wall notch by using a one-piece artificial mesh that is larger than the hernia notch, and the overall structure consists of two layers of artificial mesh and a connecting central shaft. The upper and lower artificial mesh layers can be applied to the inner and outer sides of the damaged abdominal wall, and the pressure resistance principle of dam repair is applied to strengthen the pressure resistance, which can block the pressure of the abdominal wall and will not lead to an increase in abdominal wall tension, thus reducing the postoperative pain and the possibility of recurrence. VI. What is tension-free inguinal hernia repair under local anesthesia and what are the advantages of this treatment method? There are three methods of anesthesia for inguinal hernia surgery: general anesthesia, epidural anesthesia, and local anesthesia. Local anesthesia has obvious advantages for patients of advanced age and with many comorbidities, and it is simple and easy to learn. Tension-free hernia repair surgery under local anesthesia has the advantages of low recurrence rate, minimally invasive, few complications, fast postoperative recovery and low cost, which is worth promoting. The recurrence rate of patients using tension-free artificial mesh is less than 05%, and it has the advantages of short operation time, low pain and fast recovery. 7. What are the precautions for patients before surgery? Hernia patch repair has one medium incision (about 4-6 cm long); requires hospitalization for about 3-5 days; and the full recovery time takes about 1 month for an ordinary hernia and 1 to 2 months for an extra large hernia. Things to know before hernia surgery: 1. Pre-surgical examination: including (1) Blood, urine and stool examination. (2) Examination of bleeding and clotting time. (3)General X-ray examination of chest and abdomen. (4)Electrocardiogram examination. Be cooperative with the examination, as well as inform the true situation. 2.Fill out a consent form for anesthesia and surgery. 3.The day before the surgery, the staff will shave the patient’s skin in the surgical area. 4.The day before the surgery, the nurse will give the patient a laxative to take orally for the purpose of eliminating stool from the intestinal tract. 5. Since the surgery is local anesthesia, there is no need for fasting and water fasting before surgery. How to take care of the patient at home after hernia surgery? Postoperative care: It is normal to feel some tightness and pain in the wound for 2-3 days after surgery; keep the wound clean and dry after returning home, and cover the wound with sterile gauze. Diet: increase the intake of high protein such as dairy products, eggs, fish and meat to promote wound healing; daily water intake of at least 2,000cc or more vegetables and fruits can prevent constipation Daily life: sudden coughing and force or hand pressure on the wound when moving can reduce the wound pain caused by abdominal force; please return to the clinic immediately if you have the following conditions: fever, wound redness, swelling, heat, pain, abnormal discharge and other inflammatory phenomena, persistent vomiting or wound pain. 9. How to resume normal activities after hernia surgery? In principle, normal activities are possible after hernia surgery, but excessive abdominal strain such as coughing, crying, squatting, straining to relieve stool and strenuous exercise should be avoided. However, if you cannot urinate or have not been able to urinate for more than six to eight hours, you should go to the hospital for treatment. Avoid activities that increase abdominal pressure for three months after surgery: coughing, straining to relieve stool, lifting heavy objects, prolonged stairs, hiking, biking, motorcycling, running and other strenuous exercises. Can hernia be prevented? How to prevent recurrence after surgery? Most hernias cannot be prevented, but it is possible to reduce recurrent hernia attacks. The following suggestions can help reduce recurrence of hernia: maintain a healthy weight; insist on strengthening abdominal muscles; actively prevent and control constipation and chronic cough; eat more high-fiber foods; avoid lifting, pushing, or pulling heavy objects; and give up the habit of smoking. XI. How to perform self-first aid in case of hernia impaction? Due to the lack of attention to hernia in some patients with hernia, the hernia ring is repeatedly stimulated to cause contraction and formation of impaction (stuck) after the hernia is dislodged and not reset in time. This method is suitable for early (within 3-5 hours) incarcerated hernia, where local pressure pain is not obvious and strangulation is estimated to have not yet formed, and can be tried to reset the hernia: let the patient lie in a head-down and foot-high position, ask the patient to relax as much as possible, breathe deeply, and apply a hot towel to the mass. Then hold the scrotum with the right hand and continuously and slowly push the hernia mass into the abdominal cavity and reset it manually, avoiding roughness so as not to squeeze the intestinal canal, and it is better to seek timely help from the surgeon. If the hernia still cannot be retracted, it needs to be returned to the adjacent hospital after injection of drugs to relax the hernia ring opening as needed. If the hernia is embedded for too long, surgery must be performed immediately in the hospital.