- Email: [email protected]
Hernia repair
Surg Clin N Am 83 (2003) xi–xii
Preface
Hernia repair
Ira M. Rutkow, MD, MPH, DrPH Guest Editor
This is the third hernia issue (June 1993, December 1998, October 2003) of the Surgical Clinics of North America for which I have served as guest editor. My efforts carry on the outstanding tradition that was first established by Leon Zimmerman in December 1971 and was followed by Lloyd Nyhus in April 1984. During these years, hernia surgery—groin repair, in particular—continues to be among the most discussed of all the operations performed by general surgeons. Now, more than ever, the repair of a simple inguinal hernia or a complicated incisional hernia is no longer just the perfunctory sewing together of a rent in the body. Present-day hernia operations require that a herniologist more fully understand the functional anatomy and pathophysiology of the abdominal wall and the inguinal and femoral canals. Hernia surgeons must be familiar with a myriad of surgical techniques, ranging from the traditional sutured to the mesh-based tensionfree to the laparoscopic. More importantly, the surgeon must understand the science of prosthetic materials and know how to recognize and treat all manners of complication, from a patient with an infected mesh to those suffering from a supposed mesh-induced neuralgia. As if this was not enough, present-day herniology requires that a surgeon comprehend outcome analysis and master the use of statistics to evaluate differing therapies. In addition, in a final recognition of the sophisticated but complicated world that surrounds them, modern hernologists must be cognizant of economic, social, and cultural aspects and how they impact the practice of medicine. It is certainly an interesting time to be a surgeon and to have the opportunity to participate in the exciting world of hernia surgery. 0039-6109/03/$ - see front matter Ó 2003 Elsevier Inc. All rights reserved. doi:10.1016/S0039-6109(03)00133-6
xii
I.M. Rutkow / Surg Clin N Am 83 (2003) xi–xii
In preparing this issue of the Surgical Clinics of North America, a special effort has been made to assure that the spectrum of current herniorrhaphy techniques—from Shouldice to Lichtenstein to laparoscopy to plug—are discussed. I have also made certain that there is an international representation (Canada, England, Germany, Japan, Mexico, United States) among the contributors. The very fact that there is now an American Hernia Society, a European Hernia Society, and countless hernia-themed conferences throughout the world highlights the impact that hernia surgery has on the global health care delivery system. My wife Beth and children Lainie and Eric have always provided me with the encouragement and enthusiasm necessary to organize my numerous writing projects. Without their unending love and support, I would accomplish little. I also wish to express my appreciation to Catherine Bewick at W.B. Saunders for her ever-patient administrative assistance. Last, but not least, a special personal ‘‘thank you’’ to all the contributing authors for their punctual regard of my numerous requests. Ira M. Rutkow, MD, MPH, DrPH Surgical Director The Hernia Center 222 Schanck Road Suite 100 Freehold, NJ 07728, USA E-mail address: [email protected]
Preface
Hernia repair
Ira M. Rutkow, MD, MPH, DrPH Guest Editor
This is the third hernia issue (June 1993, December 1998, October 2003) of the Surgical Clinics of North America for which I have served as guest editor. My efforts carry on the outstanding tradition that was first established by Leon Zimmerman in December 1971 and was followed by Lloyd Nyhus in April 1984. During these years, hernia surgery—groin repair, in particular—continues to be among the most discussed of all the operations performed by general surgeons. Now, more than ever, the repair of a simple inguinal hernia or a complicated incisional hernia is no longer just the perfunctory sewing together of a rent in the body. Present-day hernia operations require that a herniologist more fully understand the functional anatomy and pathophysiology of the abdominal wall and the inguinal and femoral canals. Hernia surgeons must be familiar with a myriad of surgical techniques, ranging from the traditional sutured to the mesh-based tensionfree to the laparoscopic. More importantly, the surgeon must understand the science of prosthetic materials and know how to recognize and treat all manners of complication, from a patient with an infected mesh to those suffering from a supposed mesh-induced neuralgia. As if this was not enough, present-day herniology requires that a surgeon comprehend outcome analysis and master the use of statistics to evaluate differing therapies. In addition, in a final recognition of the sophisticated but complicated world that surrounds them, modern hernologists must be cognizant of economic, social, and cultural aspects and how they impact the practice of medicine. It is certainly an interesting time to be a surgeon and to have the opportunity to participate in the exciting world of hernia surgery. 0039-6109/03/$ - see front matter Ó 2003 Elsevier Inc. All rights reserved. doi:10.1016/S0039-6109(03)00133-6
xii
I.M. Rutkow / Surg Clin N Am 83 (2003) xi–xii
In preparing this issue of the Surgical Clinics of North America, a special effort has been made to assure that the spectrum of current herniorrhaphy techniques—from Shouldice to Lichtenstein to laparoscopy to plug—are discussed. I have also made certain that there is an international representation (Canada, England, Germany, Japan, Mexico, United States) among the contributors. The very fact that there is now an American Hernia Society, a European Hernia Society, and countless hernia-themed conferences throughout the world highlights the impact that hernia surgery has on the global health care delivery system. My wife Beth and children Lainie and Eric have always provided me with the encouragement and enthusiasm necessary to organize my numerous writing projects. Without their unending love and support, I would accomplish little. I also wish to express my appreciation to Catherine Bewick at W.B. Saunders for her ever-patient administrative assistance. Last, but not least, a special personal ‘‘thank you’’ to all the contributing authors for their punctual regard of my numerous requests. Ira M. Rutkow, MD, MPH, DrPH Surgical Director The Hernia Center 222 Schanck Road Suite 100 Freehold, NJ 07728, USA E-mail address: [email protected]