The Evolution of Inguinal Hernia Repair from the Langenbeck–Gerdy Subcutaneous Technique to Durham and Subsequent Dissection Procedures: A Historical Review

Background: The history of radical hernia repair involves a period of intense surgical activity, influenced by factors of the time such as social development, hygiene, anesthesia, and antisepsis. Subcutaneous surgery, the initial option designed to avoid infections and peritonitis, was modified after the introduction of antisepsis, eventually leading to dissection surgery. Objective: We aim to analyze the publications from the period of radical hernia cures using current methodology, verifying when and how the transition occurred from subcutaneous surgery to dissection surgery. Methods: A literature review of the databases PubMed, LILACS, Cochrane Library, “Google” and university libraries is conducted. The following keywords were used: “anatomy and surgery”. A critical analysis of the known literature about this historical topic is carried out. Results: Under-vision dissection surgery, through incision of the aponeurosis of the external oblique muscle, began in England by Durham in 1866, almost 20 years before it was performed in France by Lucas-Championnière in 1885. Recurrences decreased after the introduction of the principle of closing the walls of the inguinal canal (Wood, 1860). The surgeon–anatomist Wood should be considered the first specialist in abdominal wall surgery, due to his extensive contributions from the pre-antiseptic era. The evolution of the radical cure of hernias was made possible by combining the knowledge of several countries: England, Germany, and Italy. Conclusions: Dissection surgery was initiated in England, Germany, and Italy, not in France. The influence of the French literature on the history of hernias is evident, to the detriment of the contributions of surgeons from other countries.