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General introduction and history of hernia surgery. Usher: the herniologist of the twentieth century.

Continuing specific additions of inguinal structures by his 18 th century predecessors, Cooper described the therapeutically important pectineal or superior pubic ligament, since then named after him, as well as the transversal fascia, so important in the aetiology of direct hernias The 19 th century provokes a breakthrough in the treatment of inguinal hernia, not the least because of the introduction of anaesthesia and techniques of asepsis and antisepsis into surgical practice.

Prior to these events, it remains difficult to find accounts, quoting viteză dating evenimente hitchin long term results. One can presume that high recurrence rates will have occurred in patients surviving surgical hernia repair. Anaesthesia and antisepsis in the mid 19 th century however now allowed more time-consuming dissections and elaborate techniques in order to diminish the number of recurrences.

Particularly anatomical repairs focussing on strengthening the posterior wall of the inguinal canal became feasible It was the Italian surgeon Eduardo Bassini 57 Fig. The first publication of this Paduan professor of surgery dates from Already one and two years later he presented the results of larger series of patients operated upon His technique consisted of suturing the falx aponeurotica or conjoined 51 See Thomas Morton s textbook of Thomas Morton, got 4 prizes, eventually was admitted to the Royal College of Surgeons inand was appointed house surgeon at the North London later University College Hospital.

He became assistant surgeon inbut never was given a professorship. Morton got depressed, what together with obsessive drinking ended in a suicide by taking prussic acid, on 30 October Thomson,describing the ileopubic tract, later named after him. For a biography, see Rheault et al.

The results were astonishing.

In Bassini produced a larger monograph with excellent illustrations, which became the basis of a German translated article that now made him known worldwide One of them was Ernest Juvara Fig. He published his Modifications de la procédure de Bassini pour le traitement de la cure de l hernie inguinale inin the first issue of the Romanian Journal of Surgery, of which he was the co-editor, together with the famous professor Thoma Ionescu 64, who started the journal.

BullA. WölflerW. ColeyP. Berger The famous William Halsted in transposed the spermatic cord above the external oblique aponeurosis. It became known as the Halsted I procedure. His compatriots William Halsted 67, Edmund Andrews 68 and Alexander Ferguson 69 all made some adaptations to Marcy s original technique 70, and combined it with Bassini s technique, so as to fit the procedure for both direct and indirect hernias.

An original new method of posterior inguinal wall repair, already suggested by Albert Narath and in followed by the Austrian Georg Lotheissenconsisted of using the viteză dating evenimente hitchin ligament of Cooper for repair This technique got great acceptance after its reintroduction in by Chester McVay and Viteză dating evenimente hitchin Anson However McVay s postoperative low recurrence rates were never matched by other groups TH CENTURY General developments audrey caz de cazare anaesthesia, introducing local forms of anaesthesia, had also their effect on inguinal hernia repair.

Halsted later reported the experiences of his pupil in In the 20 th century 75 a new step forward was developed in the s by the Canadian surgeon Earle Shouldice of Toronto 76 Fig. Shouldice proposed a technique based on Bassini s repair, however effectuated under local anaesthesia and consisting of a four layer muscular closure of the posterior wall, using continuous sutures His results in terms of recurrence rate were clearly superior to those obtained with previous methods The technique was taken over by many other teams from the USA or Europe 79, and became for many years a standard operation Many surgeons progressively got persuaded that surgical techniques of hernia repair had to be adapted to specific types of inguinal hernia.

It led several scientists to reconsider the anatomic principles of surgical hernia repair 81, respectively to define and categorise the different types of hernia See Marcy Halsted originally brought the spermatic cord under the skin the so-called Halsted I technique frombut later abandoned his cord transposition technique and inbricated the aponeurotic flaps of the external oblique as proposed by Edward Wyllis Andrews: it became the so-called Halsted II repair.

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A more worldwide accepted classification was presented by Lloyd Nyhus 84, who distinguished 4 types of hernia - Type 1: indirect hernia with normal inguinal ring - Type 2: indirect hernia with dilated inguinal ring - Type 3 A: direct hernia; 3 B: pantaloon hernia; 3 C: femoral hernia -- Type 4: recurrent hernia Patient, viteză dating evenimente hitchin weeks after right hernia repair, with lstill present left hernia Fig.

Same patient three weeks after left inguinal hernia repair Fig. Such tension was held responsible for the since Bassini only slowly diminishing recurrence rates In various series, circa one out of ten patients indeed continued to develop a recurrence See for details Robert Bendavid, See Nyhus et al See Lloyd Nyhuspointing to the importance of the classification in relation to surgical repair.

Already recommended by Anton Wölfler inHalsted popularized this procedure, witch was later adapted by Norman Tanner by sliding part of the rectus sheath lateral and downwards to Poupart s ligament, and so reinforcing the Bassini-type of hernia repair. Another idea to diminish tension on the muscular closure was invented by the German Martin Kirschnerwho for the first time used autologous material, namely pedicled or free fascia from the thigh to bridge the inguinal muscular defect The technique was later popularized by Geoffrey Keynes.

However also non-autologous materials soon were used to bridge the posterior wall defect. Already in did Albert Narath make use of silver filigree Years later Francis Usher 91 Fig. The tension free concept got its breakthrough with Irving Lichtenstein Fig.

Lichtenstein s results proved so good 95 that it became up till now the standard evidence-based operation A variant of the Lichtenstein technique consisted via open incision of the preand retromuscular insertion of a double-sided prolene mesh, the so-called Prolene Hernia System PHS Bates ? However it got definitely accepted after the proposal of George La Roque in He realized the approach by using an abdominal incision superior to the inguinal canal and, from within the peritoneal cavity, ligaturing the pulled back hernia sac.

The technique was combined with a Bassini repair via the same cutaneous incision.

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Moreover opening the peritoneum allowed La Roque to inspect the bowel and other abdominal organs Arnold Henry in was protagonist of an analogous approach, however via a lower abdominal midline incision Alas, both publications received too little attention.

A totally extraperitoneal approach was first executed by Cheatle inas a radical operation for cure of both inguinal and femoral hernia via a lower mid abdominal preperitoneal approach, an incision he preferred for such cure over a Pfannenstiel incision. Many authors, especially René Stoppa Fig. Equally Amid et al. See the European Hernia Society guidelines Simons et al. See StoppaStoppa et al. The strengthening of the transversalis fascia with prosthetic material, be it via an external or internal approach, got boosted by new knowledge about the aetiology of direct inguinal hernias.

A deficiency in collagen, resulting from impairment of proline and lysine hydroxylation proved to be the cause of weakening of this fascia, which remains the sole support of the posterior inguinal wall Ralph Ger was viteză dating evenimente hitchin first in to report a transabdominal closure of an inguinal hernia defect during a laparoscopy for other reasons His technique consisted of transfixing with Michel staples the peritoneal hernia sac together with the surrounding tissues viteză dating evenimente hitchin, thereby trying to prevent hernia recurrence.

The good results incited Ger to continue on the same track, and to build up experience with experimental work on animals, now inserting the stapler device via a second separate laparoscopic trocar Some years later, inthe gynaecologist S. Bogojavalensky showed a video demonstrating the laparoscopic intraabdominal incision of the peritoneal hernia sac, subsequently closing the visible muscular defect with a rolled-up piece of polypropylene mesh.

The early s saw a rapid rise of the number of publications, confirming the feasibility of laparoscopic hernia repair Whereas the first interventions were confined to a plug and patch repairlater transabdominal approaches opted for the fixation of a large preperitoneal mesh, either sutured or stapled to the posterior muscular wall A first attempt was made by applying a synthetic mesh to the peritoneal defective wall. Another approach consisted in making an intraperitoneal U-type incision in the peritoneal wall and inserting the mesh in a preperitoneal position.

Soon other surgeons proposed a complete extraperitoneal insertion of the preperitoneal mesh, namely Dulucq inFerzli et al. Even a special balloon dissector was introduced to facilitate this extraperitoneal approach Several discussions and symposia followed the introduction of laparoscopic techniques in inguinal hernia repair See Wagh et al See for a historical overview of these recent developments: José Cervantes See Ralph Ger Resembling what Franco had done from the outside in the 16th century!

Corbitt, Bob Fitzgibbons et al.

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Indeed, many surgeons worldwide had immediately started their laparoscopic experience on patients, in contrast to various other techniques in surgical practice, where animal experiments precede evaluation in humans. Moreover in an era where trials were in common use for new drugs, instruments or techniques, trials in laparoscopy on the contrary were performed scarcely and late, and yielded results only years after the already liberal use of laparoscopy. When the first trials with often small numbers of patients were published, no real differences in outcome were observed between standard Shouldice or Lichtenstein repairs and laparoscopic techniques However in all trials reduced pain, as well as earlier ambulation and return to work became strongly apparent These advantages had datând un bărbat brazilian counteract the soon observed higher risk of nerve lesion, resulting in so-called meralgia parestheticaand the higher financial costs of the use of laparoscopic apparatus.

In a later stage, many surgeons favoured the extraperitoneal TEP approach, in view of the absence of adhesion risks in the abdomen However, both TAPP and Viteză dating evenimente hitchin techniques continued to be used in the last 15 years, and are advised as evidence based techniques, equal to Lichtenstein repair A second series of discussions focussed on technical aspects of laparoscopic repair. So were surgeons concerned about the optimal size or structure of the meshor tried newer forms of cameras, trocars or instruments.

As it stands now, as well open techniques with tension free repair type Lichtenstein repairas laparoscopic techniques with preperitoneal mesh placement type TAPP or TEP are the evidence-based and accepted methods in use to deal with adult inguinal hernia It will be interesting to evaluate how these actual types of hernia repair evolve in the future. The Lichtenstein open tension-free Hernioplasty.

Inguinal hernia. Advances or Controversies? Major and minor technique of Bassini s operation, as performed by himself. Medical Record ; Anonymous: Conceptualization and measurement of physiological health for adults. Laparoscopic mesh repair of inguinal hernia using a preperitoneal approach: a preliminary report.

Comparison of Shouldice and Lichtenstein repair for treatment of primary inguinal hernia. Acta Chir Belg. Laparoscopic versus open inguinal herniorraphy: Preliminary results of a randomized controlled trial. Surgery ; Bassini E. Nuovo metodo per la cura radical radical dell ernia inguinale. Atti Congr Med Ital.

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Sulla cura radical dell ernia inguinale. Ital Chir. Sopra casi de cura radical dell ernia inguinale operata col metodo dell autore. Nuovo metodo per la cura radical dell ernia inguinale. Padova: Prosperini, Bassini E. Uber die Behandlung des Leistenbruches. New operation for the cure of indirect inguinal hernia. The TSD classification: a nomenclature for groin hernias. La hernie inguino-interstitielle et son traitement par la cure radicale.

Paris ; Berliner SD. Groin hernia: when is surgery necessary? Evolution de la pensée médicale dans le traitement chirurgical des hernies inguinales de l homme. Notes on cases of hernia which have relapsed after various operations for radical viteză dating evenimente hitchin.

New York Med. Aproximacion historica al conocimiento de la hernia. Los medicos que la describieron y trataron. In: Carbonell Tatay F. Hernia inguinocrural. The historical development of the surgical treatment of inguinal hernia. Surgery ; Casten DF. Functional anatomy of the groin area as related to the classification and treatment of groin hernias.

De Re Medica. Inguinal hernia in the new Millennium. World J. However, both TAPP and TEP techniques continued to be used in the last 15 years, and are advised as evidence based techniques, equal to Lichtenstein repair A second series of discussions focussed on technical aspects of laparoscopic repair. So were surgeons concerned about the optimal size or structure of the meshor tried newer forms of cameras, trocars or instruments. As it stands now, as well open techniques with tension free repair type Lichtenstein repairas laparoscopic techniques with preperitoneal mesh placement type TAPP or TEP are the evidence-based and accepted methods in use to deal with adult inguinal hernia It will be interesting to evaluate how these actual types of hernia repair evolve in the future.

The Lichtenstein open tension-free Hernioplasty. Inguinal hernia. Advances or Controversies? Major and minor technique of Bassini s operation, as viteză dating evenimente hitchin by himself.

Medical Record ; Anonymous: Conceptualization and measurement of physiological health for adults. Laparoscopic mesh repair of inguinal hernia using a preperitoneal approach: a preliminary report. Comparison of Shouldice and Lichtenstein repair for treatment of primary inguinal hernia.

Acta Chir Belg. Laparoscopic versus open inguinal herniorraphy: Preliminary results of a randomized controlled trial. Surgery ; Bassini E. Nuovo metodo per la cura radical radical dell ernia inguinale. Atti Congr Med Ital. Sulla cura radical dell ernia inguinale. Ital Chir. Sopra casi de cura radical dell ernia inguinale operata col metodo dell autore. Nuovo metodo per la cura radical dell ernia inguinale.

Padova: Prosperini, Bassini E. Uber die Behandlung des Leistenbruches. New operation for the cure of indirect inguinal hernia. The TSD classification: a nomenclature for groin hernias.

La hernie inguino-interstitielle et son traitement par la cure radicale. Paris ; Berliner SD. Groin hernia: when is surgery necessary? Evolution de la pensée médicale dans le traitement chirurgical des hernies inguinales de l homme. Notes on cases of hernia which have relapsed after various operations for radical cure.

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New York Med. Aproximacion historica al conocimiento de la hernia. Los medicos que la describieron y trataron. In: Carbonell Tatay F. Hernia inguinocrural. The historical development of the surgical treatment of inguinal hernia. Surgery ; Casten DF.

Functional anatomy of the groin area as related to the classification and treatment of groin hernias. De Re Medica. Inguinal hernia in the new Millennium. World J. An operation for the radical cure of inguinal and femoral hernia. Operative treatment of hernia, with a report of two hundred cases. Complications of groin hernias.

Philadelphia: J. Lippincott, ; p Cooper AP. The anatomy and surgical treatment of inguinal and congenital hernia. Cooper AP. The anatomy and surgical treatment of crural and umbilical hernia. Laparoscopic herniorrhaphy. Cocaine anesthesia in the treatment of certain cases of hernia and in operations for thyroid tumors.

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Johns Hopkins Hosp Bull. The employment of local anesthesia in the radical cure of hernia, with a note upon the nervous anatomy of the inguinal region. Le Guidon en francoys. The historical development of prosthetics in hernia surgery. Nuovo Método de operar la hernia crural. Madrid: Ibarra s widow, De Moulin D.

A history of Surgery. General introduction and history of hernia surgery. Management of Abdominal Hernias. The treatment of inguinal hernia by insertion of mesh through retroperitoneoscopy. English translation, commentaries and glossaries by Paul Ghalioungui. Oblique inguinal hernia: typical operation for its cure. The technic of modern operations for hernia. Extraperitoneal endoscopic inguinal hernia repair.

Open Laparoscopy. Surgical Laparoscopy.

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Lyon: Thibauld Payan, Franklin M. Laparoscopic hernia repair. Focus ; 1: Fruchaud H. Anatomie chirurgicale ds hernies de l aine.

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Paris: G. Living sutures in the treatment of hernia. The management of certain abdominal hernias by intra-abdominal closure of the neck. Management of indirect inguinal hernia by laparoscopic closure of the neck of the sac. An anatomic and functional classification for the diagnosis and treatment of inguinal hernia. Inguinal hernia repair using local anaesthesia. The radical cure of hernia. Johns Hopkins Hosp. The cure of the more difficult as well as the simpler inguinal ruptures.

Operation for femoral hernia by a midline extraperitoneal approach with a preliminary note on the use of this route for reducible inguinal hernia. Lancet ; 1: Hesselbach FC. Neueste anatomisch-pathologische Untersuchungen über den Ursprung und das Fortschreiten der Leisten- und Schenkelbrüche. Würzburg: Baumgartner, Himpens JM. Laparoscopic hernioplasty using a self expanding umbrella-like prosthetic patch.

Laparoscopic hernioplasty using a regular or a self expanding prosthesis: follow-up. Littré E. Œuvres d Hippocrate. Traduction nouvelle avec le texte grec en regard. Pierre Franco. Traité des hernies. In: Hahn E et al. Commentaires sur les dix grands livres de la médecine française.

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  • Cu toate acestea, o înțelegere îmbunătățită a electromagnetismului în secolul al XIX-lea a arătat că magnetismul pietrelor lodistice a fost explicat în mod corespunzător nu prin fluidele magnetice monopolice, ci mai degrabă printr-o combinație de curenți electricimomentul magnetic al electronilor și momentele magnetice ale altor particule.
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  • Transcription 1 2 Jurnalul de Chirurgie, Iaşi,Vol.
  • Vezi tu, mie mi-a fost greu sa ma apuc de chitara, fiind stangaci nu stiam daca sa ma invat pe una normala, sau sa caut o chitara pe stanga.

Mayenne : Impr. Juul P, Christensen K. Randomized clinical trial of laparoscopic versus open inguinal hernia repair. Br J Surg. Advances in extraperitoneal dissection and hernia repair.

Prolene Hernia System compared with Lichtenstein patch: a randomized double blind of short-term and medium-term outcomes in primary inguinal hernia repair. Hernia ; 6: Kirschner M. Die praktischen Ergebnisse der freien Fascien-Transplantation. Arch klin Chir. Optimal mesh size for endoscopic inguinal hernia repair. A study in a porcine model. Surg Endosc. Nerve injury during laparoscopic inguinal hernia repair.

The permanent cure of inguinal and femoral hernia. Surg Gynec Obst. Surgery for inguinal hernia in Byzantine times A. D : first scientific descriptions. History of treatment of groin hernia.

World J Surg. California Medicine ; Lichtenstein I. Hernia Repair without Disability. Louis: Mosby, Lotheissen G. Zur Radikaloperation des Schenkelhernien. Zentralbl Chir. Best practice in groin hernia repair. E altceva cand se aude ceva cand incepi sa canti, nu trebuie sa incepi cu notele neaparat. Cand incerci un acord, te dor degetele si te lasi repede, pe electrica, e mult mai usor, si daca inveti dupa tablatura, iti formezi dexteritatea precum am facut eucu unele melodii usuare, ai si satisfactie ca se aude, si incetul cu incetul mergi inainte.

La fel si cu instrumentele, am inceput cu o Hora, un kkt de amplificator no-name si un multi-effects pad Korg dinviteză dating evenimente hitchin incetul cu incetul imi iau scule mai noi Oricare dintre acești termeni poate fi prezent în expansiunea multipolă a unui câmp electricde exemplu. Un monopol magnetic, dacă există, ar avea proprietatea definitorie de a produce un câmp magnetic al cărui termen monopol este diferit de zero.

Un dipol magnetic este ceva al cărui câmp magnetic este descris predominant sau exact de termenul dipol magnetic al expansiunii multipolare. Termenul dipol înseamnă doi policorespunzător faptului că un magnet dipol conține de obicei un pol nord pe o parte și un pol sud pe cealaltă parte. Acest lucru este similar cu un dipol electriccare are o sarcină pozitivă pe o parte și o sarcină negativă pe cealaltă.

Cu toate acestea, un dipol electric și un dipol magnetic sunt fundamental diferiți. Într-un dipol electric format din materie obișnuită, sarcina pozitivă este formată din protoni, iar sarcina negativă este realizată din electronidar un dipol magnetic nu are diferite tipuri de materie care creează polul nord și polul sud.

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Din această cauză, cei doi poli ai unui dipol magnetic trebuie să aibă întotdeauna rezistență egală și opusă, iar cei doi poli nu pot fi separați unul de celălalt. Ecuațiile lui Maxwell Ecuațiile electromagnetice ale lui Maxwell raportează câmpurile electrice și magnetice între ele și la mișcările sarcinilor electrice. Ecuațiile standard prevăd sarcini electrice, dar nu prezintă sarcini magnetice.