History Perspectives and Actual Trends in the Field of Herniology

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History Perspectives and Actual Trends in the Field of Herniology

Daniel Ion
Editorials, no. 1, 2019
Article DOI: 10.21614/chirurgia.114.1.7
Herniology is one of the oldest surgical fields, and its history can basically be confused with the history of surgery in general. Its development followed the advances in anatomy, asepsia and antisepsia, and more recently, those in the field of minimally invasive technologies and synthetic materials. Until the modern age, surgery for hernias involved only the treatment of primary hernia complications, because, after the laparotomy had become a common procedure, the problem of solving incisional hernias was added; the latter is a reality that still occurs in about 10% of all laparatomies (1).
If we should mark some milestones in the evolution of surgical repair and reconstruction of the abdominal wall affected by a primary or incisional hernia, we should select from the entire labyrinth of surgical searches in this field only those concepts, gestures and techniques that were eventually validated by practice and retained as useful up to the present day. 1716 - Dimitrie Cantemir, voivode of Moldavia and member of the Academy of Sciences of Berlin, in the manuscript "Incrementa et decrementa Aulae Othomaniae" ("The History of the Growth and Decay of the Ottoman Empire") describes, for the first time, the transabdominal approach in the repair of hernias, performed at the Ottoman court by Albanian surgeons of time (2).
1871 - H. O. Marcy, the first promoter of asepsia in America, published the procedure called "simple closure of the deep inguinal opening", or the narrowing of the deep hole with a few insoluble threads crossed in the plane of the transversal fascia after the high dissection of the herniary sac (3).
1884 - Eduardo Bassini begins to practice his own procedure based on the opening of the inguinal canal with the section and reconstruction of the posterior wall in the plane of the transversal fascia, making a triple layer (4).
1887 - Bassini communicates the first study called "The radical cure of inguinal hernia" at the Italian Society of Surgery for a total of 42 surgeries in 38 patients (5).
1889 - Bassini's book, illustrated by Caterina, entitled "The New Method for the Radical Cure of the Inguinal Hernia" comes out. The book includes a series of 262 operated inguinal hernia patients, followed for 4 years, with only 4 missing cases and a recurrence rate of only 2.7% (6).
1892 - Wolfler describes the relaxation incision in the anterior blade of the abdominal muscle as an adjunct in herniorrhaphy (7).
1892 - Jusepe Ruggi resolves femoral hernias by suturing the inguinal ligament to the Cooper ligament (8).
1901 - The overlapping, described by Mayo, becomes, at the time, the most common form of autoplasty practiced in the case of umbilical and white line hernias (9). This technique was based on what Ernest Juvara had already accomplished in 1900, namely an overlap of musculo-aponevrotic plans, called the "frock-coat plasty (10).
1939 - Chester McVay proves that the transversal fascia is inferior to the Cooper ligament and not to the inguinal ligament. It restores the posterior wall by suturing the upper lip of the inguinal canal (conjunctive tendon) to the pectinate ligament (11).
1939-Tanner popularized the relaxation incision in the anterior blade of the right abdominal muscle, described by Wolfler in 1892 (12,13).
1940 - Eduard Shouldice develops Bassini's concept of making the most effective tissue repair, still valid today, by reconstructing the posterior wall of the inguinal duct in a quadruple layer (two double surjet) with a metal wire under local anesthesia (14).
1956 - Henri Fruchaud elaborates the concept of a "miopectineal hole" delimited above the aponeurotic arc of the abdominal transversal muscle, inferiorly to the upper branch of the pubicum, medially to the lateral edge of the rectus abdominis and laterally to the psoas iliac muscle (15).
1958 -Francis Usher conceives and uses "Marlex", a polyethylene polymer to replace the posterior wall of the inguinal canal by placing the prosthesis in the preperitoneal space, in the anterior way (16).
1975 - Rives and Stoppa describe a prosthetic reinforcement of the visceral sac GPRVS (Giant Prosthetic Reinforcement of the Visceral Sac) (17).
1984 - Lichetenstein L. places a polypropylene prosthesis in front of the retrofunicular transversal fascia with a lateral slit through which the spermatic funicle passes. The closure of the slit, laterally to the funicular, recalibrates the deep inguinal opening (18).
1990 - Toy describes the intraperitoneal procedure - IPOM (intraperitoneal on lay mesh) in which the deficient myopectinous aperture is covered with an EPTFE (expanded polytetrafluoroethylene) prosthesis (19).
1990 - Ramirez et al. performs, for the first time, the anterior separation of components demonstrating that the external oblique muscle can be separated from the internal oblique muscle at a relatively avascular plane, allowing the white line to be restored in the large incisional hernias (20).
1991 - Arregui describes the transabdominal properitoneal process - TAPP - openly. By removing the peritoneal flap, which covers the miopectinous hole, he placed a polypropylene mesh next to it. Finally, the prosthesis is covered by the initial dissected peritoneal flap (21).
1991 - Dulucq - the total extraperitoneal process - TEP, openly placing a prosthesis in front of the hole of the miopectinate, getting access through the sheath of the right abdominal muscle by dissecting it under the navel, from which, through the perforation of the posterior blade) (22).
1993 - LeBlanc and Booth report the first laparoscopic repair of an incisional hernia using expanded polytetrafluoroethylene (23).

Keywords: herniology