Landmarks in the history of surgical management

An appreciation of the history of hernia surgery may prevent us repeating the mistakes of the past and put in perspective the knowledge that has been accumulated in order to allow development of the successful techniques used today. The high prevalence of hernia, for which the lifetime risk is 27% for men and 3% for women, has resulted in this condition inheriting one of the longest traditions of surgical management.

• Hernia surgery has a 3500-year history (Figure 26.1)

• Castration was an essential part of the earliest operations for hernia, which carried with it an obvious stigma

• The Dark Ages until the sixteenth century halted further progress in effective treatment

• Femoral hernia was distinguished from inguinal hernia in the fourteenth century.

The great contribution of the surgical anatomists was between the years 1750 and 1865 and was called the age of dissection. The main contributors were Antonio Scarpa and Sir Astley Cooper and few major advances in our knowledge of the anatomy of the groin have been made since this time. The names of these great anatomists are Pieter, Camper, Antonio Scarpa, Percival Pott, Sir Astley Cooper, John Hunter, Thomas Morton, Germaine Cloquet, Franz Hesselbach, Friedrich Henle and Don Antonio Gimbernat.