Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2008     Volumen 33     Number 1-2
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UDK 616-007.43-089(091) ISSN 0350-2899, 33(2008) br.1-2 p.58-62
History of medicine and health culture

Hernia - Historical development of surgical treatment

Bojan Pešić, Saška Pešić, Slaviša Ristić, Zoran Milosavljević, Saša Lazović



Large prevalence of hernia, the risk of getting hernia during lifetime is 27% for males and 3% for females, resulted in the longest tradition of surgical treatment of this condition. The development of hernia surgery can be divided into three periods (the first one since the beginning of surgical treatment until late XIX century and THE appearance of E. Bassini; the second one consist the first twothirds of the twentieth century, and the third begins in the early eighties of the twentieth century). Old Egyptians, Phoenicians and Ancient Greeks knew how to diagnose hernia. What was recorded during this period were numerous devices and surgery techniques by means of which ancient people used to solve this problem. The word hernia comes from a Greek word herons which means bud or bulge. The mummy of the Pharaoh Meneptaha from 1215. B.C. shows a complete absence of scrotum, and the mummy of Pharaoh Ramzes V(1157.b.c.) suggests that he had an inguinal hernia. Greek and Phoenician terra-cottas illustrate generalised knowledge about hernia but no information about their treatment. During the dark period of the Middle Ages, using a knife was widely abandoned. In XIII cenury, surgical practice was slightly revived. A great contribution was given between 1750 and 1865 (the age of dissection). The main contribution to surgery was given by Antonio Scarpa, Sir Astley Cooper, Percival Pott, John Hunter, Franz Hesselbach, Don Antonio Gimber. The age of antisepsis, originated due to the discoveries of Joseph Lister (1827 - 1912), provided great opportunities for further development of surgical treatment of hernias. Unfortunately, the mortality rate due to peritonitis, bleeding or other complications was very high, over 7%. Relapse rate after one year went over 40% and after four years 100%. We owe to Basssini the principles of inguinal hernias reparation, whose results were exceptional (mortality under 1% and relapse rate under 10%). in 1953, Shouldice used his own methods to achieve minimal relapse rate of 0,8% during ten years in a study that included 8,317 patients. Usen used polipropilenical net for the first time in 1958. In 1979, laparascopic method of operation was attempted. In 1986 Lichtenstein described nontension technique in the surgery of inguinal hernias. In 1990 Shulc used synthetic prosthesis biomaterial in laparascopic herniotomia.
Key words: hernia, surgical treatment.

: kompletan tekst rada na srpskom jeziku
Note: full text in Serbian
  Corresponding Address:
Snežana Petrović
Gradski zavod za hitnu medicinsku pomoć
Paper received: 30.4.2008
Paper accepted: 16.7.2008
Published online: 20.10.2008
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