Edoardo Bassini and the Wound That Inspires

Edoardo Bassini, an Italian surgeon active at the turn of the 19th century, made a lasting contribution to surgery with his elucidation of the cure for inguinal hernia. The magnitude of this contribution in contrast to centuries of frustration in attempting surgical repair of hernia is described, as are Bassinis personal experiences, which may have played a role in his successful search for a cure.     

Bassini法与Shouldice法修补腹股沟疝疗效比较

目的比较腹横筋膜松弛度及韧性相当的条件下行Bassini疝修补术与Shouldice疝修补术的疗效。方法2000年3月至2006年7月,同一手术者在行腹股沟疝修补时,术中将腹横筋膜毁损不明显的72例患者随机分为两组:A组37例行Bassini疝修补术;B组35例,行Shouldice法修补。结果A组平均手术时间为(33.8±6.1)min,明显短于B组的(46.7±8.2)min,P<0.05。A组住院天数平均(4.5±2.5)d,术后发生切口(或阴囊)血肿3例(8.1%),无切口感染患者;B组住院天数(4.2±3.5)d,术后发生切口(或阴囊)血肿2例(5.7%),切口感染1例(2.9%),两组比较无统计学差异(P>0.05)。A组随访26例(70.3%),术后发生睾丸胀痛、萎缩1例(3.8%),术区紧张不适14例(53.8%),疝复发1例(3.8%);B组随访24例(68.6%),发生上述并发症的患者分别为2例(8.3%),10例(41.7%)和0,两组比较无统计学差异(P>0.05)。结论在腹横筋膜松弛度及韧性相当的条件下Bassini与Shouldice疗效相当,且较Shouldice技术要求低,易掌...     

腹股沟疝无张力疝修补术与Bassini修补术的比较

目的探讨疝环填充式无张力疝修补术(meshplug)在腹股沟疝修补中的优缺点.方法回顾性总结1998年8月至2000年2月间施行的108例次meshplug修补术与87例次Bassini修补术.结果两组术式比较,原发性疝的平均手术时间差异无显著意义(P>0.05);复发性疝的手术时间差异有显著意义(P<0.01).术中出血量、术后开始活动时间、发热时间、住院时间、术后尿潴留发生率均差异有显著意义(P均＜0.05).meshplug组术后疼痛及局部不适显著较轻.随访2～20个月,平均11个月.两组术后并发症发生率分别为2.8%和23%,复发率分别为0%和2%.结论meshplug修补术近期疗效令人满意,优于传统Bassini修补术,远期效果有待进一步观察和总结.     

Ferguson hemorrhoidectomy, modified by using the Ligasure radiofrequency coagulator

The aim of the study was the evaluation of results of modified Ferguson hemorrhoidectomy, with use of the Ligasure radiofrequency coagulator, compared to the Milligan-Morgan and Longo techniques. From January 1988 to December 2005, 3011 patients underwent Ferguson hemorrhoidectomy (1849 F, 1162 M; age range: 18 to 84 years). One thousand three hundred patients had previously been treated by medical therapy with poor results and in 225 patients (7.5%) the indication was recurrence after previous surgical treatment. All patients underwent a closed Ferguson hemorrhoidectomy (combined with anoplasty in 28 cases of post-hemorrhoidal stenosis). Eighty percent of patients were operated on with loco-regional assisted anaesthesia, and the remainder with narcosis (cases of recurrence). During the last two years we performed hemorrhoidal excision in 116 patients (4%) with the Ligasure radiofrequency coagulator, followed by continuous suturing with Vicryl 4/0. There was no intraoperative mortality. Mean operation time was 25 minutes. Postoperative complications were hemorrhage in 6 patients (0.2%) and acute urinary retention in 9 patients (0.3%). No important complications were observed in any of the patients treated with Ligasure. The hospital stay was 24 hours for 2852 patients, and 36-86 hours in the other 5%. Seventy-two percent of patients (2160) had moderate postoperative pain, while 14% (420) had severe postoperative pain necessitating repeated administration of analgesics. The 115 patients undergoing Ferguson haemorrhoidectomy plus Ligasure were discharged within 24 hours of surgery. No cases of major domiciliary haemorrhage were observed. There were 13 cases of suture dehiscence (none in the Ferguson plus Ligasure group). Five patients presented suture infection, not requiring surgical drainage, but only medical treatment with local antibiotics. These results, obtained with the modified Ferguson technique, as compared to the classical and even the most innovative hemorrhoidectomy, appear to confirm the feasibility and accuracy of this operation in almost all patients, with both a considerable reduction in costs and enhanced patient comfort and compliance.     

The letters of William Stewart Halsted and William Williams Keen

William Halsted and William Keen were two of the most distinguished surgeons in U.S. medicine. Although their personalities were completely opposite, they enjoyed a long and devoted friendship. An extensive correspondence was maintained throughout their relationship. This article examines their friendship by analyzing these letters, which are being published for the first time.     

The letters of William Stewart Halsted and John Chalmers DaCosta

William Stewart Halsted and John Chalmers DaCosta are two of the most distinguished surgeons in the history of medicine in the United States. Although their personalities were completely opposite, they enjoyed a long and devoted friendship. During their relationship, a fairly continuous correspondence was maintained. This essay has examined their friendship through an analysis of their personal letters, which are published herein for the first time.     

疝环充填式无张力疝修补术与Bassini疝修补术的临床随机对照研究

疝环充填式无张力疝修补术是一种利用人工复合材料进行无张力疝修补的最新方法。白1989年Rutkow等首先施行以来，该术式已经在美国和欧洲广泛开展。我国自1997年开始亦逐步应用。疝环充填式无张力疝修补术毕竟还是利用人工材料进行的植人性手术，相对于传统的Bassini疝修补术，其术后的早期效果和中长期效果有待系统的分析     

Surgery in Sweden at the time of Halsted

William Stewart Halsted (1852-1922) is one of the most influential persons in the history of US surgery. His surgical career can be divided into the years in New York, NY (1880-1889), and the years in Baltimore, Md (1889-1922). In addition to the important growth and development of surgery that took place in the United States during the late 1800s and early 1900s, an equally impressive growth in surgery took place in many other countries, in particular, in Western Europe. Although a small country, Sweden also saw a strong development of surgery between 1880 and 1920. In this article, some of the surgeons who were prominent in Sweden during this era (Karl Gustav Lennander in Uppsala; John Wilhelm Berg in Stockholm; and Jacques Borelius in Lund) and some of the surgical procedures that were introduced are described. In addition, a few nonsurgeons are discussed because their work significantly influenced surgery. Learning about some of the achievements in surgery during the late 1800s and early 1900s is not only educational but inspiring, and puts today's surgical practice and scientific achievements in an important historical perspective.     

The original Bassini technique in the surgical treatment of inguinal hernia

Bassini's technique represents a fundamental step in the treatment of inguinal hernia. It can be asserted that a new era in its surgical therapy started with Bassini. As many difficulties exist in comprehending the archaic language used a century ago by the Italian surgeon, the principles of his technique are analysed. It is to Bassini's credit that he invented a simple and easily performed technique to be applied in each case, respecting all the anatomic structures without using any foreign material. Accordingly, it is believed that by using this technique correctly, good results can still be obtained today.