A hernia is a defect in the abdominal wall, that is, a hole in the abdominal wall with skin on top of it, and when the abdominal pressure increases such as when you defecate, cough, or move around, the intestines protrude from the defect, and they go back when you lie down. Thus a patient starts with a mass in the abdominal wall that should not be there and disappears after lying down, a condition that is almost certainly a hernia. Hernia is a prevalent disease in the elderly, and there are very many hernia cases in the middle-aged and elderly. The causes of hernias are both reduced strength of the abdominal wall and increased intra-abdominal pressure. Elderly people often suffer from chronic bronchitis, prostate hypertrophy, habitual constipation and other diseases; long-term chronic cough, difficulty in urination and straining to defecate, resulting in increased pressure in the abdominal cavity, crowding and compressing the intra-abdominal organs to displace to the weak area of the abdominal wall. In addition, ascites caused by heart and lung diseases and liver diseases can also slowly cause an increase in abdominal pressure. In the elderly, the abdominal wall muscles and tendons are degenerated and their strength is reduced, which, together with obesity or long-term illness in bed, can easily lead to atrophy of the abdominal wall muscles and hernia. According to relevant data, there are about 20 million cases of inguinal hernia patients worldwide each year, about 800,000 cases of inguinal hernia surgery in the United States each year, and about 80,000 cases of inguinal hernia patients each year in Australia, which has a population similar to that of Beijing. A conservative estimate is that there are about 2 million inguinal hernia cases per year in China. Approximately only about 80,000 patients per year actually have inguinal surgery, so many patients are still suffering from a variety of discomforts. If the hernia is not treated in time, the abdominal wall defect will be stretched larger and larger, and more and more intestines will fall out, at which point it will be much more difficult to treat surgically. In my outpatient clinic, I met a nearly 80-year-old male patient with a medical history of less than 3 years, but the hernia developed rapidly, and the small intestine fell into the scrotum and gradually increased in size without timely treatment, so that the intestinal canal herniated into the scrotum reached the knee more than 2 years later. The penis is also buried in the scrotum, and urination is completely overflowing, which is very painful. If the contents of the hernia suddenly cannot be retracted and symptoms such as pain occur, it is called an incarcerated hernia, which is a serious complication of hernia. The clinical manifestation is a sudden increase in the size of the hernia mass, accompanied by severe pain, which cannot be retracted by lying down or pushing the mass by hand, and a tense and hard mass with tenderness. Severe cases may be accompanied by acute intestinal obstruction symptoms such as paroxysmal localized colic, nausea, vomiting, constipation, and abdominal distension. Once the hernia is embedded, there is less chance of self-retraction. In most patients, the symptoms gradually worsen and may develop into strangulated hernia if left untreated. The clinical symptoms of strangulated hernia are more severe. The necrotic intestinal canal can become infected secondary to peritonitis and septic sepsis. If left untreated, the patient’s life can be endangered, so a hernia should not be ignored and should be treated early. Traditional non-surgical treatments such as Chinese herbal medicine, hernia brace, hernia belt, injection therapy and so on are fancy, but they are proven to be ineffective and cannot solve the problem. Some so-called conservative treatments play a role in relieving symptoms for some patients who are temporarily inoperable. These methods only cater to the psychology that people can be cured without surgery, but surgical operation is necessary to completely solve the problem. It should be said that hernias are physical defects and surgery is the only reliable way to cure inguinal hernias in adults. Another important reason why surgery is necessary is also that this mass will get bigger and bigger, which for one thing affects the aesthetics, and then it does seriously affect the quality of life. To summarize, there are six major misconceptions among hernia patients: firstly, the indifferent attitude, there are many patients who believe that hernia is not painful and does not need treatment. Secondly, they are too embarrassed to go to the doctor. Some elderly patients are reluctant to inform their family and seek medical attention when they find a mass in their external genitalia. Thirdly, they are afraid of surgery. Although surgery is an invasive treatment, most of the surgeries are now minimally invasive and less damaging. The fourth fear of recurrence, modern tension-free repair, recurrence rate is very low. Less than 1%. The fifth fear of foreign body reaction, now the use of repair materials inert is very strong, should not be chemical reaction with the tissue, good tissue compatibility, used in the human body for more than 40 years of history. The sixth hope is that conservative treatment is effective. Conservative treatment can only temporarily relieve the symptoms and surgery is the only way to treat hernia. Hernia surgery With the development of medicine and technology, many traditional surgical options have been gradually updated and eliminated. The traditional open suture method, which is effective to a certain extent, requires bed rest for 3-7 days after surgery, three weeks of rest after discharge, and avoiding strenuous activities for three months, which adds a lot of trouble to the patient and has a recurrence rate of 4-10% after traditional surgery. 1980s American surgeons were the first to propose the concept of tension-free hernia repair and the Shouldice method to solve the postoperative pain and recurrence. Tension-free hernia repair with repair materials became widely available and used in the United States in the 1990s. Nowadays, millions of tension-free hernia repairs are performed worldwide every year, and the statistical results confirm that the postoperative recurrence rate of tension-free hernia repair is significantly lower than that of traditional surgery, with a recurrence rate of less than 1%. In recent years, the specialty of hernia surgery has developed rapidly, and hernia treatment has become a highly specialized discipline. New techniques and methods are constantly emerging, and more than a dozen new tension-free repair procedures are available, making the surgical treatment of hernia more and more reasonable and developing towards minimally invasive and specialized. The continuous development of new materials has also led to more reasonable repair materials and a wide range of high, medium and low price options. In 2004, I started to research minimally invasive tension-free inguinal hernia repair surgery, with an incision of only 3 cm, the first of its kind at home and abroad, which can be done in most patients under local anesthesia without fasting, water, enema, or urinary catheter. Patients can eat after the local anesthesia surgery, and they can get out of bed after the surgery, and they can be discharged from the hospital 2 days after the surgery, and there is no need to remove stitches. Thousands of cases have been successfully completed, and the recurrence rate is less than 0.5%. The smaller the trauma, the smaller the impact on the patient and the more patients can tolerate surgical treatment. Minimally invasive surgery can maximize the number of patients who undergo hernia surgery.