Ancient herniotomy surgical instruments: from Celsus to the eighteenth century

Abstract

Over the centuries hernia surgery has represented a challenge for every surgeon. Hemostasis, castration, complications, sometimes lethal, and frequent recurrences were the problems that surgeons had to face until the development of anesthesia and modern surgery. For this reason, in the past, surgeons only dared treat complications such as strangulated hernias, and the patients were obliged to wear a truss permanently. With time and owing to the growing knowledge of anatomy, techniques were developed to secure hemostasis and the reduction of the herniated viscera so as to avoid castration. From the Romans to the Middle Ages, the scalpel and the cautery were the main instruments, together with the surgeon's hands and the patient's posture, for performing hernia surgery. In the following centuries, in particular in the eighteenth century, surgical techniques flourished due to the production of several surgical instruments designed by skilful craftsmen, whose refined manufacture reveals the extent to which surgery had evolved. Some of these instruments were still in use at the beginning of this century. This paper describes the evolution of surgical instrumentation employed in hernia surgery