May 31st, 2004 the International Endo Hernia Society (IEHS) was founded in Kalithea, Greece. The founding members (see picture) chose Prof. R. Bittner to be the first president and Prof. Köckerling to be the first secretary of this new society. The IEHS was created not like a usual society with “bylaws”, membership fees, etc, but as an international network of laparoscopic surgeons highly interested in hernia surgery.
Why was it necessary to build up such a network? At that time experience of past 10-15 years showed that laparoscopic hernia surgery was not sufficiently represented in the traditional hernia societies. These societies were quite often dominated by colleagues who were specialized in ambulatory hernia surgery under local anesthesia. Most of them never became familiar with laparoscopy and often believed that laparoscopic hernia surgery is technically too demanding for the surgeon, too expensive for the hospital, and too dangerous for the patient.
Also in the established international laparoscopic societies (EAES/SAGES) leading heads followed laparoscopic hernia surgery with mistrust. There may be many reasons for their reluctance to introduce laparo-endoscopic hernia surgery which all cannot be discussed thoroughly at this place. But in the eyes of the founders of the IEHS it was hardly to understand that on the one hand laparo-endoscopic colon resections were appreciated but on the other side laparo-endoscopic hernia surgery was refused, because of the assumed high risks and the higher costs which may be involved. Randomized controlled trials and metaanalyses, which had proven several advantages of the laparo-endoscopic approach esp. regarding frequency and intensity of chronic pain, were ignored by most of the traditional surgeons. However, besides the benefits for the patients in the opinion of the founders of IEHS a further important argument for promotion of laparo-endoscopic hernia repair was that the new minimal invasive approach involves all technical elements which are necessary to train in order to become a good laparoscopic surgeon; and when facing the huge number of hernia patients, more than 20 million operations per year worldwide, all surgeon who are interested in hernia repair may have an excellent opportunity to practice and improve laparo-endoscopic techniques every day. Therefore, according to the opinion of the founding members of IEHS that when rejecting the laparo-endoscopic technique a daily and easier access to train laparoscopic skills was recklessly abandoned at that time.
Today, laparo-endoscopic hernia repair is a generally well accepted technique worldwide which is recommended by guidelines, especially in patients who suffer from bilateral hernias, recurrences after open repair, or patients with a low pain threshold respectively who want a most rapid recovery. Nevertheless despite all the well-proven advantages in comparison to the open mesh techniques the penetration rate of this new revolutionary technique is still insufficiently low in most countries. Moreover, despite more than 25 years after introduction of laparo-endoscopic hernia repair the quality of performances is still debatable at many places. Nowadays, therefore, the main goals of the IEHS are to find ways to increase the application rate as well as the quality of performance of laparo-endoscopic hernia repair (see assignments).