ABSTRACT
Until recently, hernia repair was always performed in an intuitive way-suture approximation of tissues at the border of the hernia defect. This ‘‘old-fashioned’’ approach, performed in various ways since the Middle Ages, was reasonably successful and performed worldwide until the latter half of the last century, when three major developments were shown to have benefits in terms of patient acceptance and overall success. The concepts embodied by ‘‘tensionfree’’ repair combined with advances in prosthetic materials have revolutionized the repair of primary and recurrent hernias worldwide (6,7). The abdominal wall, unfortunately, for patients with huge hernias, still contains unsolved problems and challenges for future generations of hernia surgeons.
