1993- 2000, Gdansk, Poland
In early 90-ties Professor Wojciech Gacyk from the Medical University of Gdansk in Poland initiated first randomized and prospective study testing a novel tension-free technique: the mesh-plug in comparison to the Bassini operation- most common suture inguinal hernia repair at that time. As a young general surgery resident, I was lucky to be assigned to design and conduct the study. Results showed clear advantage of the new technique and became the topic of my PhD dissertation and publication:
Witkowski P, Pirski MI, Adamonis W, Śmietański M, Drączkowski T, Śledziński Z.
Mesh-plug versus Bassini hernia operation. Randomized prospective study. Hernia 2000, 4:305- 310.
Mesh-plug technique was originally described by Robbins and Rutkow as
"The mesh-plug hernioplasty" in 1993 (Surg Clin North Am. 1993 Jun;73(3):501-12.
The main advantage of the procedure was a minimal incision and tissue dissection limiting postoperative pain and allowing for fast patient recovery and minimal risk for recurrence. Moreover, the procedure could be performed in outpatient settings with minimal cost and patient could resume daily activities next day in contrast to week or two spending in bed after traditional sutures repair (I still remember such a long postoperative recovery).
Presenting our results at the European Hernia Society Congress in Madrid in 1999, I was lucky again,
I met Dr Ira Rutkow from US- who agreed to come to Poland to promote his mesh-plug technique.
INTERNATIONAL CONFERENCE OF THE MODERN TENSION FREE HERNIA REPAIR TECHNIQUES.
GDANSK, POLAND, 2000.
Next year, under leadership of Professor Zbigniew Sledzinski, we organized in Gdansk, the first national hernia conference promoting different tension free techniques with live surgery transmitted to the congress venue. And, I was lucky again. Dr Rutkow requested me to assist him during his live surgical performance and interpreting his description of the procedure for Polish speaking conference audience. Below, some pictures from that day in 2000.
During the same conference, other tension-free techniques were also presented: Lichteinstein technique, PHS, Trabucco futureless technique, Shouldice operation. This was turning point for hernia surgery in Poland. After 100 years, Bassini operation was replaced by much more efficient tension-free techniques.
My colleagues: Professor Andrzej Matyja and Dr Rafal Solecki from Krakow, Dr Maciej Smietanski from Gdansk, Professor Stanislaw Dabrowiecki from Bydgoszcz organized the Polish Hernia Club and established new tension-free standards for hernia repair in Poland. Dr Maciej Smietanski, who after my departure to USA, took over lead in hernia research in Gdansk, has been actively involved in the Scientific Committee of the European Hernia Society and after 14 years he organized hernia conference in Gdansk again, this time the Congress of the European Hernia Society in 2014, where I was invited to co-chair one of the sessions- a very nice gesture.
EUROPEAN UNION HERNIA TRIALISTS COLLABORATION 1998- 2000
At the end of 90-ties, when more studies discovered advantages of different mesh techniques over traditional suture repair, EU sponsored collaboration of hernia specialists and authors of randomized studies. The goal was to prepare a comprehensive report based on literature review as well as to establish standards and unified protocols for future studies comparing different hernia rapair techniques.
I was lucky to be invited and participated in two meetings: in Madrid in 1999and in Oxford in 2000.
Several important reports were published as a direct result of this collaboration:
Cost-effectiveness of alternative methods of surgical repair of inguinal hernia.
Vale L, Grant A, McCormack K, Scott NW; EU Hernia Trialists Collaboration.
Int J Technol Assess Health Care. 2004 Spring;20(2):192-200.
Value of updating a systematic review in surgery using individual patient data.
McCormack K, Grant A, Scott N; EU Hernia Trialists Collaboration.
Br J Surg. 2004 Apr;91(4):495-9.
Laparoscopic techniques versus open techniques for inguinal hernia repair.
McCormack K, Scott NW, Go PM, Ross S, Grant AM; EU Hernia Trialists Collaboration.
Cochrane Database Syst Rev. 2003;(1):CD001785. Review.
Open mesh versus non-mesh repair of groin hernia: meta-analysis of randomised trials based on individual patient data [corrected].
Grant AM; EU Hernia Trialists Collaboration.
Hernia. 2002 Sep;6(3):130-6. Epub 2002 Jul 26. Review. Erratum in: Hernia 2002 Dec;6(4):204.
Laparoscopic versus open groin hernia repair: meta-analysis of randomised trials based on individual patient data.
Grant AM; EU Hernia Trialists Collaboration.
Hernia. 2002 Mar;6(1):2-10.
Repair of groin hernia with synthetic mesh: meta-analysis of randomized controlled trials.
EU Hernia Trialists Collaboration.
Ann Surg. 2002 Mar;235(3):322-32.