Evolution of hernia repair: a salute to Professor Piero Pietri.

This subject has been well covered in recent years. Yet it seems appropriate to search for major advances in hernia methodology during the last 100 years. Eduardo Bassini is credited with pioneering the modern era. His "triple layer" repair was corrupted through the years and, as a result, he did not receive sufficient credit for his attention to the posterior inguinal wall. Chester McVay, renowned surgeon-anatomist, renewed interest in the Cooper's ligament and the posterior inguinal wall. Surgeons from the Universities of Washington and Illinois perfected approaches to the posterior inguinal wall. Thus, these investigators paved the way for several effective posterior hernia operations. The name of Usher will forever be remembered in terms of practical prosthetic mesh (polypropylene). This material, as well as others, has become an important addition to the surgeon's armamentarium. Rene Stoppa reminded us of the Pascal principle and clearly demonstrated how giant prostheses can remain in the preperitoneal space without the need for sutures. Tension-free operations, plug techniques, and laparoscopic hernia methodology must await further analysis.