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Trabucco's technique and the history of hernia surgery

The story of the birth and spread of the Trabucco technique for inguinal hernia surgery well can be summed up with a phrase that has become famous in the history of surgery: "The history of hernia surgery is the history of surgery." These are the words of Lloyd M. Nyhus, a prominent U.S. surgeon of the last century who devoted much of his professional life to hernia surgery.

In fact, all the great Surgeons in history have tried their hand at hernia surgery, not least because hernias represent one of the absolute most common diseases of surgical interest.

Since the last century, however, abdominal hernia surgery has undergone a major boost, thanks to the introduction of new techniques related to the development of biomedical technology, including:

  • The introduction of nets, which allowed the surgical act to be simplified and new "tension-free" techniques to be developed
  • The advancement in local anesthesia methods, which has allowed hernias to be operated on on an outpatient basis
  • the research and development of biomaterials
  • The advent of laparoscopic techniques.

Together, these factors allowed three main outcomes to be achieved: rapid recovery, reduction in recurrence (from 5 to 20 percent of cases before the introduction of the nets to less than 1 percent), and reduction in incapacity for work (from 3 months to less than 15 days).

However, the use of nets and the stitches for their suturing in the groin region has increased cases of postoperative groin pain . Such pain may be due either to the stitches themselves or to "crumpling" of the mesh due to the inherent characteristics of the technique used. 

inguinal hernia trabucco method, Trabucco technique, inguinal hernia surgery, salvatore cuccomarino, Cuccomarino MD,

Trabucco's technique

In 1989 Italian surgeon Ermanno Trabucco, in his Long Island, New York, practice, developed a new technique for inguinal hernia surgery. Trabucco's technique is based on two crucial elements: no stitches are used to fix the mesh, and the mesh is placed in a space in the inguinal region such that the mesh itself cannot crumple.

This results in patients operated on with this technique (and with the mesh designed by Dr. Trabucco) having a significantly reduced incidence of postoperative pain.

I learned Trabucco's technique for inguinal hernia from Prof. Trabucco himself, with whom I had the good fortune to have an intense relationship both personally and remotely, by telephone, in the last years of his life. Ermanno Trabucco was one of the pillars of abdominal wall surgery; and his technique, developed in the 1980s, represents one of the milestones in the history of inguinal hernia repair.
Trabucco's technique is simple, standardized, easily reproducible, and easy to teach. It is, in fact, the classic "ideal" surgical technique, which admits of no discussion, no interpretation, and no error.

Technique of Trabucco and Cuccomarino, MD: an ancient history...

So deeply was I convinced of the extraordinary effectiveness of Trabucco's technique-which I have been adopting now for 15 years in my patients-that I decided to actively collaborate with the organization founded by Prof. Trabucco to contribute to its dissemination around the world. Thus, it was also thanks to my work and the surgeries I performed around the world, both in the operating rooms of Congresses on Abdominal Wall Surgery and in a great number of hospitals, that Trabucco's technique is now used in European countries such as Spain and Poland, and non-European countries such as Mexico and Panama. And soon I will leave for Argentina to continue the work of knowledge sharing, for nothing is more important there is in the Art of Surgery: thus, actively continuing my scientific collaboration, and my friendship, with the enterprise created by Dr. Trabucco for the development and production of prostheses and techniques for abdominal wall surgery with technological content that is always on the cutting edge.

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Dr. Salvatore Cuccomarino
Cuccomarino, MD
Medical Surgeon specializing in general surgery
Coloproctology, advanced laparoscopic surgery, hernia and abdominal wall surgery
Corso Galileo Ferraris 3
Phone 0110438161