General introduction and history of hernia surgery

Abstract

The high prevalence of hernia, for which the lifetime risk is 27 % for men and 3 % for women [1], has resulted in this condition inheriting one of the longest traditions of surgical management. 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 [2]. The Egyptian tomb of Ankhmahor 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 (Fig. 1.1) [3]. 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 fecal fistula in the scrotum and signs of attempts at surgical relief.