Foreword

The history of medicine emphasizes that because of epidemiological relevance, the hernia has always drawn the careful attention of general practitioners and especially of surgeons. Hernia sites are many and the disease can become disabling and, with its complications, dangerous.

The surgeon's goal is to carry out an operation with fast recovery, as painless as possible. and without recurrence risk. At the end of the last century, technical improvements (especially the employment of synthetic meshes and, for certain types of hernias and laparoceles, the laparoscopic approach) led to a fundamental evolution of this surgery with a increased development of new methods of repair.

For this reason, any scientific contribution, including the various clinical aspects, is interesting, such as the evolution of new operative techniques or the evaluation of the results of methods commonly used in daily surgical activity. Recently, particular interest has been aroused by the prevention and treatment of complications and by the new problems connected with the widespread use of prosthetic materials.

This book's Editor is Dr Angelo Guttadauro, my excellent university assistant and my dear friend. Keen on this surgery even with original ideas, Dr Guttadauro has produced a good update with the contribution of specialists from several countries. The final result is effective, so I am sure that this further scientific contribution will be welcomed by all the surgeons and in particular by the specialists dealing routinely with this pathology.

> **Francesco Gabrielli** Full Professor of General Surgery, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

Preface

Hernias of the abdominal wall include all cases in which the intestine protrudes from the site where it is contained due to a muscle-aponeurotic weakness or a pathological enlargement of natural orifices. Due to congenital causes and physiological ageing of the organism, all conditions of increased pressure inside

Hernias of the abdominal wall are amongst the most treated diseases in all hospitals

Over the past 20 years, the introduction of prostheses in hernia surgery has almost completely replaced plastic abdominal wall interventions that use the patient's tissues to repair the hernial defect. Almost simultaneously, the introduction of laparoscopy has contributed to innovation in the treatment of this disease.

Today there are hundreds of types of non-absorbable, partially or fully absorbable,

Many interventions that treat hernial disease can now be performed in most parts of the world in outpatient surgery with local anaesthesia, guaranteeing a rapid recovery for the patients and an early return to normal daily activities. This has allowed for a reduction in public health spending and a greater availability of beds

Complications, however rare, seem to be minor in the centres dedicated to the

The purpose of this book is to gather the experiences of distinguished authors from all over the world in order to assess the most common techniques, clarify ideas with the aim of providing guidance, and become acquainted with the most modern

> **Dr. Angelo Guttadauro** Researcher in General Surgery, Department of Medicine and Surgery, University of Milano-Biccocca,

> > Italy

Head of Hernia Center Monza-Brianza, Clinical Unit of General Surgery,

biological synthetic prostheses. New surgical techniques, conformed to the introduction of new types and forms of prosthetic material, can guide the surgeon

in choosing the best approach for each individual patient.

for the hospitalisation of more serious diseases.

treatment of hernial pathology.

technological innovations.

the abdomen contribute to the onset of the disease.

of the world.
