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An appreciation of the history of hernia surgery may prevent us repeating the mistakes of the past and put in perspective the knowledge that has been accumulated in order to allow development of the successful techniques used today. The high prevalence of hernia, for which the lifetime risk is 27% for men and 3% for women, has resulted in this condition inheriting one of the longest traditions of surgical management.
Hernia surgery has a 3500-year history (Figure 26.1)
Castration was an essential part of the earliest operations for hernia, which carried with it an obvious stigma
The Dark Ages until the sixteenth century halted further progress in effective treatment
Femoral hernia was distinguished from inguinal hernia in the fourteenth century.
The great contribution of the surgical anatomists was between the years 1750 and 1865 and was called the age of dissection. The main contributors were Antonio Scarpa and Sir Astley Cooper and few major advances in our knowledge of the anatomy of the groin have been made since this time. The names of these great anatomists are Pieter, Camper, Antonio Scarpa, Percival Pott, Sir Astley Cooper, John Hunter, Thomas Morton, Germaine Cloquet, Franz Hesselbach, Friedrich Henle and Don Antonio Gimbernat.
This is the new, expanded and updated edition of the key text currently available for the first stages of the MRCS examination. Mirroring the exam syllabus, it offers the trainee a clear understanding of the core knowledge required for examination success and incorporates new material reflecting recent developments and the new examination. The chapters have been written by acknowledged experts, many of whom are themselves involved in the training and examining of candidates. Designed to achieve maximum efficiency in learning, the content provides ample detail, key points and suggestions for further reading. In addition to a detailed index, each chapter has its own table of contents to enhance ease of use. It will be indispensable for the new trainee, and will also provide established surgeons and other healthcare professionals working in the surgical environment with a modern, authoritative overview of the key areas of surgical practice.
One of the first challenges for aspiring surgeons to negotiate is the intercollegiate MRCS examination, which has replaced similar examinations previously run by the four Royal Surgical Colleges. The first edition of Fundamentals of Surgical Practice has become a recommended and standard text for the MRCS examination largely due to the reputation of its contributors. As editors of the second edition we are delighted that the majority of our authors have signed up to a revision and update of their chapters. There are some new contributors and some of our senior authors have revised their chapters with junior colleagues attuned to modern surgical thinking.
Technological aspects of surgery have undergone rapid change in the last two decades. A parallel change has taken place in the educational concepts underpinning transfer of basic knowledge into surgical practice. The knowledge base itself may not have changed a great deal but its method of presentation has. Therefore, we have selected authors with a gift for imparting the enthusiasm of their specialist interest in a straightforward and easily understood way but without missing out on the detail. In this edition the alimentary system has been expanded into two chapters on Upper gastrointestinal and Lower gastrointestinal surgery and a separate chapter on Hernia management has been added to emphasise the importance of surgery of the abdominal wall as an expanding area of specialist interest.
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