1. 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, and because of the small diameter of the sphincter, the intestinal canal cannot pass (when the sphincter canal is thicker, the intestinal canal can easily pass then a hernia is formed), allowing only the abdominal fluid to flow through the sphincter canal and accumulate in the sphincter cavity, forming a syringomyelia. The sphincter in female fetuses is called Nück’s canal, and if fluid accumulation occurs, it is called Nück’s cyst. 2. What are the dangers of inguinal hernia, syringomyelia, etc.? 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 considered as inguinal hernia entrapment. When the small intestine and ovary are embedded in the hernia sac, the blood circulation of the small intestine and ovary is impaired, resulting in ischemic necrosis of the intestine and ovary, which can cause severe pain in the child and, in severe cases, nausea, vomiting, abdominal distention, blood in the stool and fever. In addition, in boys with incarcerated hernia, prolonged pressure on the spermatic cord can lead to testicular ischemia and cause testicular infarction. Sphincter effusion is not large in size and tension is not high, so it has little effect on the body, but if the tension is high, it may affect the blood supply to the testes and produce testicular atrophy. 3. How to treat inguinal hernia and syringomyelia? Although the peritoneal sphincter can continue to be occluded after birth, children with hernias rarely have the possibility of self-healing. Therefore, inguinal hernias should be surgically treated after diagnosis to prevent repeated inguinal hernia intussusception, even in premature infants (especially for those with a history of recurrent intussusception and giant hernias, which should be operated as early as possible). 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 testicular blood supply and produce testicular atrophy, and the surgery is not restricted by age. 4. 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 1.0-1.2cm long), each has its own advantages.