Studies and Researches

Prof. Giuseppe Amato

From new evidence in physiology and pathogenesis to regenerative hernia surgery

Prof. Giuseppe Amato’s research has made a significant contribution to our understanding of the pathophysiology of the groin.

Thanks to his scientific research, which was the first of its kind in the world, Prof. Amato discovered the underlying causes of hernia disease. Through years of anatomical, histological and clinical studies, it was possible to identify in detail the structural and functional alterations that cause the degeneration of the abdominal wall tissues, which is the basis for the formation of hernias.

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The discovery of the septum inguinalis

One of the most important milestones in this scientific journey was the discovery of the septum inguinalis, an anatomical structure that had never been described before and which plays a key role in the physiological balance of the inguinal region.

The recognition of the septum inguinalis has made it possible to understand, for the first time, the pathogenic mechanisms that lead to the progressive loss of resistance and tissue breakdown responsible for the formation of hernias.

From discovery to therapy: the birth of the dynamic regenerative scaffold

These anatomical and pathophysiological discoveries paved the way for a new therapeutic paradigm in the treatment of abdominal hernias: the concept of dynamic regenerative scaffolding (DRS).

Based on the idea of restoring the biological and dynamic function of the muscle barrier rather than replacing it with inert materials, DRS represents a revolutionary approach compared to traditional surgery.

The first clinically applied device based on this new philosophy was ProFlor, the first generation of dynamic regenerative scaffold, designed to provide permanent dynamic support capable of stimulating muscle, nerve and vascular regeneration in the inguinal region, restoring the functional integrity of the inguinal barrier.

On this conceptual basis, a second generation of SDR was developed: the Stenting & Shielding (S&S) Hernia System. This newly conceived device combines a dynamic expandable stent with a protective shield.

Thanks to its revolutionary bioengineering design, the Stenting & Shielding Hernia System enables the entire procedure to be completed in just a few seconds, without incisions, without trauma, and without fixation devices.

This dissection-free, fixation-free, incision-free approach marks the definitive transition from traditional mesh-based repairs to a fully regenerative, reproducible, and physiological treatment of abdominal wall hernias — the true surgery of the future.

Curious to discover how the next-generation solution for hernia repair actually works?

Find out more about the new surgical devices

Further information

Peer-reviewed scientific articles on inguinal pathophysiology:

  1. Sphincter-like motion following mechanical dilation of the internal ring during indirect inguinal hernia procedure. Hernia 2009;13:67-72
  2. Histological findings of the internal inguinal ring in patients having indirect inguinal hernia. Hernia 2009;13;259-62
  3. Nerve degeneration in inguinal hernia specimens. Hernia 2011;15:53-58
  4. Pathological anatomy of hernia disease. Hernia 2011;15:S46-4765-7
  5. Muscle degeneration in inguinal hernia specimens. Hernia 2012;16:327–331
  6. Physiopathology of hernia disease. Hernia 2012;17 (Suppl 1): S159-160Histological findings in direct inguinal hernia. Hernia 2013;17(6):757-63
  7. Histological findings in direct inguinal hernia. Hernia 2013;17(6):757-63
  8. Multiple ipsilateral inguinal hernias. If undetected source of complications and re-interventions. Hemia 2014; 18 (Suppl 2):26
  9. Addressing hernia genesis. It’s impact in the surgical management of inguinal protrusions. Hemia 2014; 18 (Suppl 2):87
  10. Combined inguinal hernia, a progressive protrusion disease. Hernia (2015) (Suppl 2):SI95-S340
  11. Combined inguinal hernia in the elderly. Portraying the progression of hernia disease. Int J Surg. 2016 Sep;33 Suppl 1:S20-9.
  12. External hernia of the supravesicalis fossa: a misidentified protrusion. More frequent than imagined, riskier than perceived. Hernia (2016) 20 (Suppl2):S198
  13. The septum inguinalis: a neglected feature of the inguinal backwall showing significant implications in hernia genesis. Hernia (2016) 20 (Suppl 2):S175
  14. External hernia of the supravesical fossa. A misidentified protrusion with high risk of incarceration. Hernia (2017) 21 (Suppl 2):S173
  15. Physiopathology of inguinal region & hernia genesis. Highlighting the visceral impact theory. Hernia (2017) 21 (Suppl 2):S208
  16. Lipoma of the fossa femoralis mimicking a femoral hernia. Report of 2 cases Int J Surg Case Rep. 2018; 49: 223–227
  17. The Septum Inguinalis: A Clue to Hernia Genesis? J Invest Surg. 2020 Mar;33(3):231-239
  18. Inguinal Hernia: The Destiny of the Inferior Epigastric Vessels and the Pathogenesis of the Disease. Surg Technol Int. 2020 Mar 18;36.