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Transcription 1 2 Jurnalul de Chirurgie, Iaşi,Vol. Jurnalul apare ca o necesitate în condiţiile cerute de noile forme de pregătire a rezidenţilor în chirurgie şi se angajează să pună la dispoziţia tinerilor chirurgi din diverse specialităţi, cunoştinţele şi modelele de bază a pregătirii lor ca specialişti pentru noul mileniu. Editori onorifici Richard M. Satava U. Paul Allen Wetter U. Republicarea parţiala sau în întregime a articolelor se poate face numai cu menţionarea autorilor şi a Jurnalului de chirurgie.

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Чтооо. - протянул Ричард, снова вскакивая на ноги. - О Эпонина. - воскликнула Николь. - Я так рада.

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Hîrţan 1E. Târcoveanu 2 1 doctorand Universitatea de Medicină şi Farmacie Gr. Tănăsescu Vl. Buţureanu Universitatea de Medicină şi Farmacie Gr. Popa Iaşi Clinica A. Spiridon Universitatea de Medicină şi Farmacie Gr. Dimofte, Simona Nicolescu, V. Boboc, E. Tarcoveanu Clinica I Chirurgie I. Simion 1B. Popa 2T. Grecu 2V. Șurlin 3Daniela Cernea 1F. Ciocîrlan, V. Stog, M.

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Târcoveanu 2C. Bradea 2A. Vasilescu 2 1 doctorand Universitatea de Medicină şi Farmacie Gr. Buzduga 1I.

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Fabian, Emilia Pătruţ, I. Şimon, V. Spiridon University Hospital Gr. Strat, A. Vasilescu Clinica I Chirurgie I. In view of its existence in different kinds of animals, and in particular of primates, one can assume that already prehistoric human beings were affected with the disease. Inguinal hernia repair has made enormous progress throughout the ages. Surgical techniques have rapidly evolved since Eduardo Bassini proposed his first successful reconstruction of the inguinal floor.

The various adaptations of his technique did however not result in a substantial reduction in the number of recurrences. The tension free repair, introduced by Irving Lichtenstein, caused a dramatic drop in the recurrence rate and became the procedure of choice.

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Since the introduction of laparoscopic techniques, these methods became equally accepted for inguinal hernia, in particular in western regions where financial aspects play a less prominent role.

The future will tell how hernia repair will evolve in the next decades. Correspondence to: Prof. In view of its existence in different kinds of animals 2, and in particular of primates curba max curve slimming, one can assume that already prehistoric human beings were affected with the disease curba max curve slimming.

Written proof of this statement became available from manuscripts and founds in Mesopotamian 5 and Egyptian ardeți grăsimea toracică fără greutăți cultures. So does the famous papyrus Ebers, dating from around BC, refer to patients suffering from inguinal hernia, quoting its appearance during coughing 7.

Another passage 8 mentions its treatment: Then you shall say concerning it This is a swelling of the coverings of his abdomen, an illness which I will treat.

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It is the heat of his bladder in front of his belly which creates it. Falling to the ground, it returns likewise. You should heat shemen it to imprison it in his belly.

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You treat it like the sahemen treatment 9. They can be divided into four categories: 1.

Historical monographs, amongst others René Stoppa et al. Articles in journals, amongst others R. Carlson inMichael Sachs et al. McClusky et al. Articles dealing with specific aspects of the history of anatomy, pathology or treatment of hernia: these will be cited at their respective places in this article. See also Skandalakis et al. See Skandalakis et al. So do we read in the Hippocratic Corpus, that hernia was the result of either drinking water from large rivers 11, or curba max curve slimming a traumatic event to the belly In the 3 rd century BC, Alexandrian medical scientists clearly curba max curve slimming surgery for hernia.

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They obtained preoperative sedation with a root extract of mandrake, while haemostasis was achieved with vascular ligature The original manuscripts were lost with the destruction of the library of Alexandria, but were transmitted and later reiterated in Roman times, not the least by the encyclopaedist Aulus Cornelius Celsus fl AD. Herein he describes reduction of hernia content by taxis, and states that at operation not only haemostasis is realised by ligature, but also that the testes are spared One century later Heliodorus fl.

Galennot curba max curve slimming wound surgeon of gladiators, but also physician of two consecutive Roman emperors, ascribed the origin of hernias to rupture of the peritoneum and overstretching of the overlying fascia and muscles His treatment consisted of a ligature of the hernia sac, together with the spermatic cord, and resection of the testicle Galen s words became like a medical Bible and were followed and applied for centuries.

With the fall of the Western Roman Empire inByzantine medicine took over this Greco-Roman tradition and the treatments of Galen in particular However Paul of Aegina ca.

He either opened the hernia sac and reduced its content into the belly by invaginating it with a probe, or applied cauterisation to the skin, overlying the hernia, aiming at scarring the overstretched peritoneum Incarcerated hernias were apparently not treated, since not mentioned in the texts of the Antique Masters See Nunn p See for this passage of Hippocrates: Littré Vol.

The most notorious writer Albucasis discusses hernia at length in chapters 65 to 67 of the Maqalat, the 30 th book of his al-tasrif In his chapter 67 Albucasis acknowledges that early hernia swellings may reduce spontaneously, but mostly may become permanent through formation of adherences.

They develop as a consequence of distension and weakening of the inguinal peritoneum and should be treated by cauterisation In chapter 65 the author elaborates on scrotal hernia, called oudara maaiya or enterocele. Here the author is very reluctant to perform cauterisation. Instead, after placing the patient in a supine position, the hernia is progressively reduced, after which the patient is operated upon, the hernia sac transfixed with a cross stitch, and the testicle removed Finally the scrotum is drained inferiorly.

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The Arab influence of cauterising the pubic region in case of inguinal hernia became widely adopted in the western late Middle Ages, in particular through the Latin transcription of Albucasis al-tasrif by Gerard of Cremona in Toledo in the late 12 th century So did Guy de Chauliac borrow extensively from Albucasis textbook. For inguinal hernia he proposes six different treatments 25 : 1.

After skin incision, the hernia sac is transfixed and the distal spermatic cord with the testicle is amputated method of Galen. Cauterisation of the external swelling with the red hot iron method of Albucasis. Scar formation by using a cauterium potentiale, a plaster with escharotic capacity, as for instance arsenic method of Theodoric of Cervia [ ]. Applying a transcutaneous suture around the spermatic cord, and tying it on an external wooden slat, until the cord becomes sectioned method of Roger of Salerno [late 12 th century].

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Incising the suprapubic area and introducing a hot iron cauter directly on the spermatic cord method of Lanfranchi of Milan [? After incision, applying a golden thread around the spermatic cord, to tie it just enough to ensure closure of the hernia sac method of Guy de Chauliac The surgical textbooks of Guy became the New Testament in surgery. For more than three hundred years, the different methods were in use, with a progressive preponderance for Guy s technique with the Golden Thread.

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See the corresponding chapters on hernia: pp There is also the English translation and commentary by M. Let the patient lie on his back, in front of you ; make a transverse incision of approximately three finger dimensiune 12 la dimensiune 0 pierdere în greutate, over the neck of the inguinal swelling and dissect the subcutaneous membranes.

Then take a wooden stiletto and apply it on the top side of the peritoneal sac, so as to reduce it in the interior of the abdomen; use two good sutures above the stiletto and knot them; then remove the wooden stiletto with care not to section the peritoneum, nor to touch the testicle, as I teached you previously; continue by applying a normal wound dressing; when the sutures fall off, the wound curba max curve slimming infecting and the peritoneal retraction prevent recurrence.

Cauterisation has the most beneficial effects in the inguinal region. For de Chauliac s treatise on hernia, see de Chauliac ff. So did Roland of Parma fl. This may on the one hand have been the result of a better knowledge of anatomical structures, on the other of new emerging expertise in instrument making.

Several surgeons benefited from the dawn of printing to ventilate their increased knowledge and ideas concerning such surgical hernia repair. So did Pierre Franco ca publish the curba max curve slimming monograph, primarily devoted to herniotomy, and written in vernacular.

In the second edition of his work, published in under the title Traité des hernies, Franco discusses in detail the nature, cause and treatment of herniation Surgical treatment differed according to the type of hernia.

In the inguinal form bubonoceleFranco remains very conservative and after reduction only uses a plaster or a truss In scrotal hernia with omental content epiplocele or with intestinal content enterocele surgical treatment proves indicated and generally consisted of castration at that side. In sliding hernia hitherto not described in literature Franco opens the hernia sac, separates the viscera from the peritoneal sac and subsequently proceeds as mentioned before

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