It has to be recognized that Raymond Reads’ early scientific work for the first time postulated a systemic disease leading to groin herniation and performed systematic analyses. However, his findings were neglected by the surgeon’s scientific community for a long time. The reason might be that his pioneering feat took place in the shadow of tremendous technical progress. Furthermore, his theory was probably too awkward for that time. Is groin herniation just a pure technical feature and the surgeon the only one who is responsible for success or failure? Or are there individual patient-related features influencing tissue composition, and is groin herniation, therefore, a kind of systemic disease? Unfortunately, most of the surgeons were predominantly interested in the technical issues at that time.

Ahead of his time, Raymond Read was one of the first surgeons who expressed and investigated the hypothesis of a biological approach of groin herniation, a fact that cannot be overestimated. Recent worldwide epidemiological data prove beyond doubt that pure technical progress does not succeed in improving the overall results in regard to recurrence rates [1, 2, 3]. In particular, the constant rates for re-operations due to hernia relapse argue in favour of a biologic approach to groin herniation and recurrence development. In the meantime, this early assumption of Read has, furthermore, been confirmed using molecular-biology tools [4, 5, 6], and the definition and isolation of a multifactorial genetic disorder is imminent. Thus, the existence of herniosis in at least some of the patients is more than evident.

Read’s idea of an individual patient-related biological approach may have fundamental implications for progress in the hernia field. Within oncology it has been known for many years that the individual patient’s response is of major importance, and tools are being developed to predict the response. Surgeons will need similar approaches, as no truth may be found in a standardised patient given a standardised therapy with standardised outcome. The latter scenario, unfortunately, is anything but based on scientific data. In the field of hernia, a constant linear increase in the onset of recurrences was demonstrated in a recent meta-analysis of randomized controlled trials [1], as well as in a large population-based study [2] that prove a rather unpredictable outcome. This constant rise over a span of years leaves no room for doubt about the overestimated influence of technique and thus again confirms Read’s biologic approach. It is not the least contribution of Raymond Read that he has drawn the patient with his individual traits and diseases back on the centre stage of scientific interest. Modern surgeons have not only to be technically prepared but also to learn more about the patient’s individual response capabilities.