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That short biographical note, written for the centenary of Henri Fruchaud's birth, regretably appears somewhat late. Two components of the rich personality of this uncommon man are underlined: his passion for surgery, supported by anatomical researches which made him a well known author; and his patriotic devotion during this century two World Wars, when - testimonies prove this - his surgical skill, imagination and physical resistance rendered outstanding services recognized by the Nation. The critical evocation of his anatomical and surgical publications insists on the work of Henri Fruchaud in Hernia Surgery and try to make the reader sharing with the redactor and many worldwide surgeons admirative feelings.

Like Hernia Surgery, itself, its complications must be regularly reviewed for permanent teaching. The necessity of this information is linked to the daily frequency of hernia cures. Complications are rather infrequent in classical repairs, where difficulties and pitfalls have been listed since a long time. Nevertheless their list is large and deserves to be recalled. Coelioscopic hernia surgery, recently appeared, revealed some complications which were unknown in classical surgery; its evaluation, to day in progress, should take account of these.

Objective: The authors provide an assessment of mechanisms leading to hernia recurrence after laparoscopic and traditional preperitoneal herniorrhaphy to allow surgeons using either technique to achieve better results., Summary Background Data: The laparoscopic and traditional preperitoneal approaches to hernia repair are analogous in principle and outcome and have experienced a similar evolution over different time frames. The recurrence rate after preperitoneal herniorrhaphy should be low (< 2%) to be considered a viable alternative to the most successful methods of conventional herniorrhaphy., Methods: Experienced surgeons supply specifics regarding the mechanisms of recurrence and technical measures to avoid hernia recurrence when using the preperitoneal prosthetic repair. Videotapes of laparoscopic herniorrhaphy in 13 patients who subsequently experienced a recurrence also are used to determine technical causes of recurrence., Results: Factors leading to recurrence include surgeon inexperience, inadequate dissection, insufficient prosthesis size, insufficient prosthesis overlap of hernia defects, improper fixation, prosthesis folding or twisting, missed hernias, or mesh lifting secondary to hematoma formation., Conclusions: The predominant factor in successful preperitoneal hernia repair is adequate dissection with complete exposure and coverage of all potential groin hernia sites. Hematoma mesh lifting and inadequate lateral inferior and medial inferior mesh fixation represent the most common causes of recurrence for surgeons experienced in traditional or laparoscopic preperitoneal hernia repair.