We can safely say that the very existence of hernias goes back through multiple millenniums. Hernias were first documented in papyrus scrolls from ancient Egypt that date back to about 1550 BC. These scrolls addressed a variety of medical conditions, including hernias. The physician Hippocrates (460–370 BC) provided a thorough description of inguinal hernias and their treatment in the ancient Greek literature on hernias. In his medical writings, the Roman physician Celsus (25 BC–50 AD) extensively discussed hernias, outlining their symptoms and indicators as well as possible treatments.

Over the centuries, the understanding and treatment of hernias continued to evolve. The renowned anatomist Andreas Vesalius gave information on the anatomy of the abdominal wall and hernia causes in the 16th century. In the 19th century, surgical techniques for repairing hernias were refined, and by the early 20th century, hernia surgery had become a common procedure.

So, have do we define hernias in this modern age ? We say that a hernia is a condition that occurs when an organ or tissue pushes through a weak spot in the muscle or tissue that normally holds it in place. This can happen in various parts of the body, but the most common types of hernias occur in the abdominal area. What are the common types of hernia ?

1. Inguinal hernia (view image): Considered to be the most common type of hernia existing in the human population, defined as a protrusion of an intraabdominal organ or structure through a abdominal wall weak spot in the groin ( inguinal) region.
2. Umbilical hernia (view image): Occurs when an intraabdominal organ or structure ( such as fatty tissue ) protrude through a abdominal wall weak spot in the umbilical ( bellybutton ) region.
3. Incisional hernia (view image): also often classified as a postoperative hernia, it's a abdominal wall defect that is at the site of previous surgical incision (surgical scar)
4. Hiatal Hernia (view image): happens when a part of, or the complete stomach pushes through the opening on the diaphragm and into the chest cavity. We will mention more about hiatal hernias in detail in our following blog on GERD (gastro-oesophageal reflux disease)

The most common symptom that is related to the existence of a hernia is pain. Pain is usually increasing while there is some physical activity being performed ( such as bending, lifting heavy objects or gym workouts ).  It's important to note that hernias are accompanied by a visible bulge, which becomes more prominent when that region is exposed to an increased pressure ( achieved during lifting objects, running, workouts etc. ).

What about the treatment of hernias ? Well, it's a straight forward answer-surgery. Today, the advancements in technology and it's implementation in every day surgical practice, have drastically improved the long term outcome and the recovery time for patients undergoing hernia surgery. What do we mean by technological advancements ? Let's just highlight several of them. First, the invention and implementation of a mesh in reinforcement of the weakend abdominal wall, has greatly reduced the rate of hernia reoccurrence. Surgical meshes have undergone significant evolution and development over time, leading to the creation of more effective and safer products. So, how have the surgical meshes evolved ? Let's take a look:

1. Materials: Once constructed of animal tissues like pig or cow intestines, surgical mesh has since been created of synthetic materials including polypropylene, polyester, and ePTFE (expanded polytetrafluoroethylene). More resilient, less prone to infection, and less likely to be rejected by the body are synthetic meshes.
2. Design: Surgical mesh designs have also changed over time. Meshes were originally flat and basic, but they are now offered in a variety of sizes, forms, and features, such as multiple layers, adjustable tension, and reinforced edges. These adjustments have made it possible to position the weakening abdominal wall in a better location and with better support.
3. Biocompatibility: Since the advent of coatings that encourage tissue ingrowth, lessen inflammation, and lower the risk of infection, surgical meshes have become more biocompatible.
4. Laparoscopic mesh placement: As a result of the development of laparoscopic surgery, it is now possible to implant surgical meshes through tiny incisions, causing less tissue damage, a quicker recovery, and fewer difficulties.
5. 3D printing: The use of 3D printing technology has made it possible to create personalized meshes that are sized and shaped to precisely match the demands of the patient, leading to better results and fewer issues.

We mentioned laparoscopy. I'm sure that by now, that the vast majority of people that have ever searched online about surgical treatment have come across the phrase "laparoscopic". Well, the word comes from the Greek words "lapara" meaning "flank" and "skopein" meaning "to see". Laparoscopic hernia treatment has become the gold standard, reflecting both the recovery, as well as the long term results. So, how is it done exactly ? Laparoscopic procedures are performed through small in size incisions on the abdominal wall, ranging from 5-10mm, with major emphasis on the ergonomics of the ports, which enables me to have the optimal utilisation of the surgical instruments needed for successful and long lasting positive outcome of the performed surgery.

In 10 years of specialist practice ( both in the UAE and Serbia ) I have strived for excellence in laparoscopic hernia management. I am offering the full range of laparoscopic hernia management ( inguinal, postoperative, umbilical and hiatal ) as a daystay procedure in more then 90% of the cases.