‘Say #LIRA’
My name is Hakan Gök. I am a surgeon based in Istanbul, Turkey, working at a hernia surgery center called Hernia Istanbul®. I am a board member of the EHS, and I visited a fellow EHS board member, Prof. Salvador Morales-Conde, with the EHS travel grant in Seville, Spain, from June 24 to 30, 2024.
Prof. Morales-Conde is the Head of the General Surgery Department at Virgen Macarena University Hospital in Seville and the President-Elect of the European Hernia Society (EHS). He will take over the presidency at the 47th EHS Annual Hernia Congress in Paris from June 4-6, 2025. His contributions to the abdominal wall and hernia surgery are tremendously impressive. He has a highly enviable career. He organized the 30th EHS Hernia Congress in Seville in 2008. Recently, he successfully served as the President of two prestigious associations: Asociacion Espanola de Cirujanos (AEC) and the European Association for Endoscopic Surgery (EAES). In addition to hernia surgery, he is heavily involved in bariatric surgery and colorectal surgery, hosting national and international training courses in these fields.
One of his most significant international activities related to hernia surgery is the Virtual Hernia University project, known as ‘Hernia U.’ Together with my esteemed colleagues, Prof. Flavio Malcher from New York (the incoming President of the American Hernia Society, taking office in September 2024) and Prof. Eduardo Parra-Davilla from Miami, they have successfully implemented this project for years. Hernia U, sponsored by BD Company and endorsed by EHS, offers a website (herniau.com) with basic and advanced hernia courses, anatomy lectures, and monthly live surgical broadcasts. I highly recommend following this very educational and up-to-date platform. During my stay in Seville, I had the pleasant coincidence of participating in one of these live broadcasts. Instead of being behind a screen, I was right in the operating room next to Salva. Watching him successfully apply the LIRA technique on a complex midline incisional hernia was an amazing experience.
During my visit, I observed a very satisfying number and variety of hernia repairs, most of which were laparoscopic repairs. This was precisely my aim: to improve my knowledge of advanced laparoscopic hernia surgery. Seville is perfect for this. Salva’s LIRA (Laparoscopic Intracorporeal Rectus Aponeuroplasty) technique, which he developed and pioneered, is a popular ventral hernia repair technique due to its broad indication range and ease of application. It can be used not only for midline hernias but also for lateral hernias. Sometimes, it needs to be partially extraperitoneal, such as in suprapubic and lumbar hernias, where it is called TAPE (Trans-Abdominal Partially Extraperitoneal). The latest version is Extraperitoneal LIRA, which involves applying the midline LIRA technique preperitoneally. There are scientific publications on all of these. Compared to eTEP ventral, it is an easy-to-apply technique, quite effective, and has good long-term results.
In Seville, I met with many #HerniaFriends, some of whom I knew in person and some through social media, including Juan Ramón Naranjo, Juan Antonio Bellido Luque, Julio Gómez-Menchero, Eugenio Licardie, Javier Valdes Hernandez, Pietro Mascagni, Andrea Balla, and Javier Estebanez García. They all were friendly and helpful. I thank them all.
I exclusively focus on abdominal wall and hernia surgery, and in every step I take to improve in this field, I learn something from each interaction and catch the nuances. This hernia trip provided me with significant insights, and I have no doubt it will impact my daily practice. I am grateful to EHS for providing this opportunity. I encourage you to become an EHS member and apply for hernia travel grants. Enhance your knowledge and make new friends. It’s a wonderful experience, indeed!
Seville, located in southern Spain, is the capital of the Andalusia region. Its people are warm (and the weather is very hot this season). The city hosts important historical landmarks, including the UNESCO World Heritage-listed Seville Cathedral. The street food is fantastic. It’s a city worth visiting.
With regards,
Hakan Gök
