General Introduction and History of Hernia Surgery

  • Andrew Kingsorth
  • David L. Sanders


The high prevalence of hernia, for which the lifetime risk is 27% for men and 3% for women [87], has resulted in this condition inheriting one of the longest traditions of surgical management. Descriptive anatomy of the anterior abdominal wall dates back over 6000 years, to the beginning of civilization, the Valley of the Nile and the ancient Egyptian papyri. These texts, often by unknown authors, were written in a time when medicine was magico-religious and the first steps in inductive reasoning were being taken. The Egyptians (1500 BC), the Phoenicians (900 BC) and the Ancient Greeks (Hippocrates, 400 BC) diagnosed hernia. During this period a number of devices and operative techniques have been recorded. Attempted repair was usually accompanied by castration, and strangulation was usually a death sentence. The word ‘hernia’ is derived from the Greek (hernios), meaning a bud or shoot. The Hippocratic school differentiated between hernia and hydrocele—the former was reducible and the latter transilluminable [88]. The Egyptian tomb of Ankh-ma-Hor at Saqqara dated to around 2500 BC includes an illustrated sculpture of an operator apparently performing a circumcision and possibly a reduction of an inguinal hernia [94] (Fig. 1.1). Egyptian pharaohs had a retinue of physicians whose duty was to preserve the health of the ruler. These doctors had a detailed knowledge of the anatomy of the body and had developed some advanced surgical techniques for other conditions and also for the cure of hernia. The mummy of the pharaoh Merneptah (1215 BC) showed a complete absence of the scrotum, and the mummified body of Rameses 5th (1157 BC) suggested that he had had an inguinal hernia during life with an associated faecal fistula in the scrotum and signs of attempts at surgical relief.


  1. 1.
    Arregui ME. Preperitoneal repair of direct inguinal hernia with mesh. Presented at Advanced laparoscopic surgery: the international experience. Indianapolis, IN: 20–22 May 1991.Google Scholar
  2. 2.
    Arregui ME, Navarrette J, Davis CJ, et al. Laparoscopic inguinal herniorrhaphy: techniques and controversies. Surg Clin N Am. 1993;73(3):513–27.PubMedCrossRefGoogle Scholar
  3. 3.
    Barie PS, Mack CA, Thompson WA. A technique for laparoscopic repair for herniation of the anterior abdominal wall using a composite mesh prosthesis. Am J Surg. 1995;170:62–3.PubMedCrossRefGoogle Scholar
  4. 4.
    Bogojavalensky S. Laparoscopic treatment of inguinal and femoral hernia (videopresentation). 18th Annual Meeting of the American Association of Gynecological Laparoscopists, Washington, DC. 1989.Google Scholar
  5. 5.
    Campos L, Sipes E. Laparoscopic hernia repair: use of a fenestrated PTFE graft with endo-clips. Surg Laparosc Endosc. 1993;3(1):35–8.PubMedGoogle Scholar
  6. 6.
    Carbajo MA, Martin del Olmo JC, Blanco JI, de la Cuesta C, Toledano M, Martin F, Vaqueto C, Inglada L. Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc. 1999;13:250–2.PubMedCrossRefGoogle Scholar
  7. 7.
    Carbajo MA, Martin del Olmo JC, Blanco JI, de la Cuesta C, Martin F, Toledano M, Pernac C, Vaquero C. Laparoscopic treatment of ventral abdominal wall hernias: preliminary results in 100 patients. J Soc Laparoendosc Surg. 2000;4:141–5.Google Scholar
  8. 8.
    Corbitt J. Laparoscopic herniorrhaphy. Surg Laparosc Endosc. 1991;1:23–5.PubMedGoogle Scholar
  9. 9.
    Corbitt J. Laparoscopic herniorrhaphy: a preperitoneal tension-free approach. Surg Endosc. 1993;7:550–5.PubMedCrossRefGoogle Scholar
  10. 10.
    DeMarie EJ, Moss JM, Sugerman HJ. Laparoscopic intraperitoneal polytetrafluoroethlene (PTFE) prosthetic patch repair of ventral hernia. Surg Endosc. 2000;14:326–9.CrossRefGoogle Scholar
  11. 11.
    Dion YM, Morin J. Laparoscopic inguinal herniorraphy. Can J Surg. 1992;35:209–12.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Dulucq JL. Treatment of inguinal hernia by insertion of a subperitoneal patch under pre-peritoneoscopy. Chirurgie. 1992;118(1-2):83–5.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Dulucq JL. Treatment of inguinal hernias by insertion of mesh through retroperitoneoscopy. Post Grad Surg. 1992;4(2):173–4.Google Scholar
  14. 14.
    Felix E, Scotts S, Crafton B, et al. Causes of recurrence after laparoscopic hernioplasty. Surg Endosc. 1998;12:226–31.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Ferzli GS, Massad A, Albert P. Extraperitoneal endoscopic inguinal hernia repair. J Laparoendosc Surg. 1992;2(6):281–6.PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Fitzgibbons RP. Laparoscopic inguinal hernia repair. In: Zucker KA, editor. Surgical laparoscopy update. St Louis: Quality Medical; 1993. p. 373–934.Google Scholar
  17. 17.
    Gazayerli MM. Anatomic laparoscopic repair of direct or indirect hernias using the transversalis fascia and iliopubic tract. Surg Laparosc Endosc. 1992;2:49–52.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Gazayerli MM, Arregui ME, Helmy HS. Alternative technique: laparoscopic iliopubic tract (IPTR) inguinal hernia repair with inlay buttress of polypropylene mesh. In: Ballabtyne GH, Leahy PF, Modlin IR, editors. Laparoscopic surgery. Philadelphia: WB Saunders; 1993.Google Scholar
  19. 19.
    Ger R. The management of certain abdominal herniae by intra-abdominal closure of the neck of the sac. Ann R Coll Surg Engl. 1982;64:342–34.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Ger R, Monro K, Duvivier R, et al. Management of inguinal hernias by laparoscopic closure of the neck of the sac. Am J Surg. 1990;159:370–3.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Heniford BT, Park A, Ramshaw BJ, Voeller G. Laparoscopic ventral and incisional hernia repair in 407 patients. J Am Coll Surg. 2000;190(6):645–50.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Holzman MD, Parut CM, Reintgen K, et al. Laparoscopic ventral and incisional hernioplasty. Surg Endosc. 1997;11:32–5.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Kavic MS. Laparoscopic hernia repair. Surg Endosc. 1993;7:163–7.PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
    LeBlanc KA, Booth WV. Avoiding complications with laparoscopic herniorrhaphy. Surg Laparosc Endosc. 1993;3(5):420–4.PubMedPubMedCentralGoogle Scholar
  25. 25.
    LeBlanc KA, Spaw AT, Booth WV. Inguinal herniorrhaphy using intraperitoneal placement of an expanded polytetrafluoroethylene patch. In: Arregui ME, Nagan RF, editors. Inguinal hernia: advances of controversies? Oxford: Radcliffe Medical Press; 1994. p. 437–9.Google Scholar
  26. 26.
    LeBlanc KA, Booth WV. Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endo. 1993;3(1):39–41.Google Scholar
  27. 27.
    LeBlanc KA, Booth WV, Spaw AT. Laparoscopic ventral herniorrhaphy using and intraperitoneal onlay patch of expanded polytetrafluoroethylene. In: Arregui ME, Nagan RF, editors. Inguinal hernia: advances or controversies? Oxford: Radcliffe Medical Press; 1994. p. 501–10.Google Scholar
  28. 28.
    LeBlanc KA, Booth WV, Whitaker JM. Laparoscopic repair of ventral hernias using an intraperitoneal onlay patch: report of current results. Contemp Surg. 1994;45(4):211–4.Google Scholar
  29. 29.
    LeBlanc KA, Booth WV, Whitaker JA, Bellanger DE. Laparoscopic incisional and ventral herniorrhaphy: our initial 100 patients. Am J Surg. 2000;180(3):193–7.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    LeBlanc KA. Current considerations in laparoscopic incisional and ventral herniorrhaphy. J Soc Laparoendosc Surg. 2000;4:131–9.Google Scholar
  31. 31.
    McKernan JB, Laws HL. Laparoscopic repair of inguinal hernias using a totally extraperitoneal prosthetic approach. Surg Endosc. 1993;7:26–8.PubMedPubMedCentralCrossRefGoogle Scholar
  32. 32.
    Park A, Gagner M, Pomp A. Laparoscopic repair of large incisional hernias. Surg Laparosc Endosc. 1996;6(2):123–8.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Park A, Birch DW, Lovrics P, et al. Laparoscopic and open incisional hernia repair: a comparison study. Surgery. 1998;124:816–22.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Phillips EH, Carroll BJ, Fallas MJ. Laparoscopic preperitoneal inguinal hernia repair without peritoneal incision: technique and early clinical results. Surg Endosc. 1993;7:159–62.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Popp LW. Endoscopic patch repair of inguinal hernia in a female patient. Surg Endosc. 1990;5:10–2.CrossRefGoogle Scholar
  36. 36.
    Popp LW. Improvement in endoscopic hernioplasty: transcutaneous aquadissection of the musculo fascial defect and preperitoneal endoscopic patch repair. J Laparoendosc Surg. 1991;1(2):83–90.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Ramshaw BJ, Escartia P, Schwab J, Mason EM, Wilson RA, Duncan TD, Miller J, Lucas GW, Promes J. Comparison of laparoscopic and open ventral herniorrhaphy. Am Surg. 1999;65:827–32.PubMedPubMedCentralGoogle Scholar
  38. 38.
    Salerno GM, Fitzgibbons RJ, Filipi C. Laparoscopic inguinal hernia repair. In: Zucker KA, editor. Surgical laparoscopy. St Louis: Quality Medical; 1991. p. 281–93.Google Scholar
  39. 39.
    Schultz L, Graber J, Pietrafitta J, et al. Laser laparoscopic herniorrhaphy: a clinical trial, preliminary results. J Laparoendosc Surg. 1990;1:41–5.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Spaw AT, Ennis BW, Spaw LP. Laparoscopic hernia repair: the anatomical basis. J Laparoendosc Surg. 1991;1:269–77.PubMedCrossRefGoogle Scholar
  41. 41.
    Toy FK, Smoot RT. Toy-Smoot laparoscopic hernioplasty. Surg Laparosc Endosc. 1991;1:151–5.PubMedGoogle Scholar
  42. 42.
    Toy FK, Smoot RT. Laparoscopic hernioplasty update. J Laparoendosc Surg. 1992;2(5):197–205.PubMedCrossRefGoogle Scholar
  43. 43.
    Andrews WE. Imbrication of lap joint method: a plastic operation for hernia. Chicago Med Rec. 1895;9:67–77.Google Scholar
  44. 44.
    Amid PK, Shulman AG, Lichtenstein IL. Critical suturing of the tension free hernioplasty. Am J Surg. 1993;165:369–72.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Battle WH. Abstract of a clinical lecture on femoral hernia. Lancet. 1901;157:302–5.CrossRefGoogle Scholar
  46. 46.
    Bassini E. Nuova technica per la cura radicale dell’ernia. Atti del Associazione Medica Italiano Congresso. 1887, vol. 2. p. 179–82.Google Scholar
  47. 47.
    Bassini E. Nuova technica per la cura dell’ernia inguinale. Societa Italiana di Chirurgica. 1887, vol. 4. p. 379–82.Google Scholar
  48. 48.
    Bassini E. Ueber die Behandling des Leistenbruches. Arch Klin Chir. 1890;40:429–76.Google Scholar
  49. 49.
    Bull WT. Notes on cases of hernia which have relapsed after various operations for radical cure. N Y Med J. 1891;53:615–7.Google Scholar
  50. 50.
    Catterina A. Bassini’s operation. London: Lewis; 1934.Google Scholar
  51. 51.
    Catterina A. L’operatione di bassini der la cura radicale dell’ernia inguinale. L. Capelli: Bolognia; 1932.Google Scholar
  52. 52.
    Cheatle GL. An operation for radical cure of inguinal and femoral hernia. Br Med J. 1920;2:68–9.PubMedPubMedCentralCrossRefGoogle Scholar
  53. 53.
    Cheatle GL. An operation for inguinal hernia. Br Med J. 1921;2:1025–6.PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    Cheselden W. The anatomy of the human body. 12th ed. London: Livingston, Dodsley, Cadell, Baldwin and Lowndes; 1784.Google Scholar
  55. 55.
    Coley WB. The operative treatment of hernia with a report of 200 cases. Ann Surg. 1895;21:389–437.PubMedPubMedCentralCrossRefGoogle Scholar
  56. 56.
    Cooper A. The anatomy and surgical treatment of inguinal and congenital hernia I. London: T. Cox; 1804.Google Scholar
  57. 57.
    Czerny V. Studien zur radikalbehandlung der hernien. Wien Med Wochenschr. 1877;27:497–500.Google Scholar
  58. 58.
    De Chauliac G. La Grande Chirurgie composee en 1363. Revue avec des notes, une introduction sur le moyenage. Sur la vie et les oeuvres de Guy de Chauliac par E. Nicaise. Paris: Felix Alcan. 1890.Google Scholar
  59. 59.
    Devlin HB. History of surgical procedures. In:Sonderdruck aus hygiene in chirurgischen alltag. Berlin: De Gruyter; 1993.Google Scholar
  60. 60.
    Ferguson AH. Oblique inguinal hernia. Typic operation for its radical cure. J Am Med Assoc. 1899;33:6–14.CrossRefGoogle Scholar
  61. 61.
    Franco P. Traite des hernies contenant une ample declaration de toutes leurs especes et outres excellentes parites de la chirurgie, assauoir de la Pierre, des cataracts des yeux, et autres maladies, desquelles comme la cure est perilluese, aussi est elle de’ peu d’hommes bien exercee. Lyon: Thibauld Payan. 1561.Google Scholar
  62. 62.
    Fruchaud H. Le traitement chirurgicale des hernies de l’aine chez l’adulte. Paris: G Dion; 1956.Google Scholar
  63. 63.
    Fruchaud H. L’Anatomie chirurgicale de l’aine. Paris: C. Dion; 1956.Google Scholar
  64. 64.
    Haidenthaller J. die radicaloperationen der hernien in der klinik des Hofraths Professor Dr. Billroth, 1877–1889. Arch Klin Chir. 1890;40:493–555.Google Scholar
  65. 65.
    Halsted WS. The operative treatment of hernia. Am J Med Sci. 1895;110:13–7.CrossRefGoogle Scholar
  66. 66.
    Halsted WS. The radical cure of hernia. Bull Johns Hopkins Hosp. 1889;i:12–3.Google Scholar
  67. 67.
    Halsted WS. The operative treatment of hernia. Am Jo Med Sci. 1895;110:13–7.CrossRefGoogle Scholar
  68. 68.
    Halsted WS. An additional note on the operation for inguinal hernia. In:Surgical papers by William Stuart Halsted, vol. 1. Baltimore: John Hopkins; 1924. p. 306–8.Google Scholar
  69. 69.
    Henry AK. Operation for femoral hernia by a midline extraperitoneal approach: with a preliminary note on the use of this route for reducible inguinal hernia. Lancet. 1936;ii:531–3.CrossRefGoogle Scholar
  70. 70.
    Kocher T. Chirurgische operationslehre. Jena: Verlag von Gustav Fischer; 1907.Google Scholar
  71. 71.
    LaRoque GP. The permanent cure of inguinal and femoral hernia. A modification of the standard operative procedures. Surg Gynecol Obstet. 1919;29:507–11.Google Scholar
  72. 72.
    Le Dran HF. The operations in surgery. London: Dodsley and Lay; 1781. p. 59–60.Google Scholar
  73. 73.
    Lichtenstein IL, Shulman AG, Amid PK, Montilier MM. The tension-free hernioplasty. Am J Surg. 1989;157:188–93.PubMedCrossRefGoogle Scholar
  74. 74.
    Lister J. Note on the preparation of catgut for surgical purposes. Br Med J. 1908;1:125–6.PubMedPubMedCentralCrossRefGoogle Scholar
  75. 75.
    Lockwood CB. The radical cure of femoral and inguinal hernia. Lancet. 1893;2:1297–302.CrossRefGoogle Scholar
  76. 76.
    Lockwood CB. The radical cure of hernia, hydrocele and varicocele. Edinburgh: Young; 1898.Google Scholar
  77. 77.
    Lytle WJ. Internal inguinal ring. Br J Surg. 1945;32:441–6.CrossRefGoogle Scholar
  78. 78.
    Lytle WJ. The deep inguinal ring, development, function and repair. Br J Surg. 1970;57:531–6.PubMedCrossRefGoogle Scholar
  79. 79.
    MacEwen W. On the radical cure of oblique inguinal hernia by internal abdominal peritoneal pad and the restoration of the valved form of the inguinal canal. Ann Surg. 1886;4:89–119.PubMedPubMedCentralCrossRefGoogle Scholar
  80. 80.
    Marcy HO. The cure of hernia. J Am Med Assoc. 1887;8:589–92.CrossRefGoogle Scholar
  81. 81.
    Marcy HO. A new use of carbolized catgut ligatures. Boston Med Surg J. 1871;85:315–6.CrossRefGoogle Scholar
  82. 82.
    Marcy HO. Note on mortality after operation for large incarcerated hernia. Ann Surg. 1900;31:65–74.PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    McEvedy PG. Femoral hernia. Ann R Coll Surg Engl. 1950;7:484–96.PubMedPubMedCentralGoogle Scholar
  84. 84.
    Mikkelsen WP, Berne CJ. Femoral hernioplasty: suprapubic extraperitoneal (Cheatle-Henry) approach. Surgery. 1954;35:743–8.PubMedGoogle Scholar
  85. 85.
    Musgrove JE, McCready FJ. The Henry approach to femoral hernia. Surgery. 1949;26:608–11.PubMedGoogle Scholar
  86. 86.
    Pott P. Treatise on ruptures. London: Hitch and Howes; 1757.Google Scholar
  87. 87.
    Primatesta P, Goldacre MJ. Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol. 1996;25:835–9.PubMedPubMedCentralCrossRefGoogle Scholar
  88. 88.
    Read RC. The development of inguinal herniorrhaphy. Surg Clin N Am. 1984;64:185–96.PubMedCrossRefGoogle Scholar
  89. 89.
    Read RC. Marcy’s priority in the development of inguinal herniorrhaphy. Surgery. 1980;88:682–5.PubMedGoogle Scholar
  90. 90.
    Reinhoff WF Jr. The use of the rectus fascia for closure of the lower or critical angle of the wound in the repair of inguinal hernia. Surgery. 1940;8:326–39.Google Scholar
  91. 91.
    Rutkow IM. A selective history of gro