Did you know…? Groin (inguinal) hernias
Did you know that groin (inguinal) hernias were described by the Egyptians as early as 1500BC?
The Ebers papyrus is one of the oldest surviving medical records (it was named after Georg Ebers, a German Egyptologist, who bought it in Luxor in 1873). It was written in approximately 1500 BC and contains nearly 700 so called prescriptions (some dating from 3000 BC) for the treatment of various disorders, including the inguinal hernia.
Hernia treatment in those days was basic to say the least and indeed it was hundreds of years before real development in treatment came along. There were advances throughout the 1800’s but the advent of anaesthesia and antiseptic surgery lead to the first anatomical treatment of inguinal hernia.
Many surgeons (the authors included!) still remember the Bassini hernia repair – although not the very first one!. Edoardo Bassini (1844-1924) was an Italian surgeon who suffered a bayonet wound to the groin whilst fighting for Giuseppe Garibaldi’s army. He remained in hospital for almost six months and during this time began his extensive study of the anatomy of the groin. Ultimately he declared;
“In order to achieve a radical cure of hernia it is absolutely essential to restore those conditions in the area of the hernial orifice, which exist under normal conditions”.
In other words, the anatomy that he understood so well had to be restored to normal to prevent the hernia from coming back. At the University of Padua, Italy between 1883 and 1889, Bassini went on to operate on 274 hernias and collected data on 216 patients over almost 5 years. This so-called prospective approach to surgical outcomes was almost unheard of at the time. He was able to identify just eight hernias that came back (4%) and 11 postoperative infections (5%).
Bassini presented his first results in Padua in Italian during a local surgical congress but within a few years his new method had become a classic. His achievement is even more impressive when we see that all subsequent methods of inguinal hernia surgery until introduction of artificial materials were actually variants of Bassini’s concept.
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