Page 4 - herina surgery and possible lawsuits

1858 Retzius Retropubic space (Bogros space is extension of the
Retzius space)

1908 George Cooper’s Ligament repair
Lotheissen

1876 Czemy Describe ligating and excising the indirect
peritoneal sac through the external ring

1881 Lucas- High ligation at deep ring, opened the external
Championniere oblique aponeurosis to expose the entire inguinal
canal

(4) Era of Hernia Repair under Tension (Nineteenth to Midtwentieth Century)

• Lister introduced antiseptic surgery about 1870, followed by Halsted's introduction of

gloves in 1896 and Von Mickulicz translated antiseptic surgery to aseptic surgery in
1904, the scene was set for the techniques of modem hernia surgery to develop.
• Marcy, Steele and Kocher had done sac management through the external inguinal

nng. Lucas-Championmere was first to split the external oblique aponeurosis, lay
open the inguinal canal, and imbricates the roof during closure. The sac was excised
under direct vision down to the mtemal ring.

• Marcy in 1871, first three of the modem principles of inguinal surgery were used,
antisepsis/ asepsis, high ligation of the sac, and tightening of the mtemal nng.
Unfortunately, these procedures failed to achieve the goal of radical cure of inguinal

hernia. [10]
Table 2: Time line and contribution of the legendary contributor surgeon of Era of Hernia
Repair under Tension.[ 1,10, 21, 23]
Year Surgeon Technique of hernia repair

1870 Lister Antiseptic surgery

1896 Halsted Introduction of Gloves;

1904 Von Mickulicz Aseptic surgery

Marcy Described first three principles of inguinal
1871 surgery; antisepsis/ asepsis, high ligation of the
sac, and tightening of the internal nng.

10