from pptx import Presentation
from pptx.util import Inches, Pt, Emu
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR
from pptx.enum.shapes import MSO_SHAPE
from pptx.oxml.ns import qn

# ---------- palette ----------
NAVY = RGBColor(0x12, 0x26, 0x3A)
NAVY_DARK = RGBColor(0x0A, 0x18, 0x28)
GOLD = RGBColor(0xC9, 0x9A, 0x3D)
CREAM = RGBColor(0xF6, 0xF1, 0xE7)
PARCH = RGBColor(0xFB, 0xF8, 0xF2)
TEXT_DARK = RGBColor(0x2A, 0x2A, 0x28)
TEXT_MUTE = RGBColor(0x5B, 0x5B, 0x57)
WHITE = RGBColor(0xFF, 0xFF, 0xFF)

SLIDE_W = Inches(13.333)
SLIDE_H = Inches(7.5)

prs = Presentation()
prs.slide_width = SLIDE_W
prs.slide_height = SLIDE_H
BLANK = prs.slide_layouts[6]


def add_slide(bg=PARCH):
    s = prs.slides.add_slide(BLANK)
    rect = s.shapes.add_shape(MSO_SHAPE.RECTANGLE, 0, 0, SLIDE_W, SLIDE_H)
    rect.fill.solid()
    rect.fill.fore_color.rgb = bg
    rect.line.fill.background()
    rect.shadow.inherit = False
    # send to back is default since first shape
    return s


def no_line(shp):
    shp.line.fill.background()
    shp.shadow.inherit = False
    return shp


def add_rect(s, x, y, w, h, color, line=False):
    shp = s.shapes.add_shape(MSO_SHAPE.RECTANGLE, x, y, w, h)
    shp.fill.solid()
    shp.fill.fore_color.rgb = color
    if not line:
        shp.line.fill.background()
    shp.shadow.inherit = False
    return shp


def add_text(s, x, y, w, h, text, size=18, color=TEXT_DARK, bold=False, italic=False,
             align=PP_ALIGN.LEFT, font="Georgia", anchor=MSO_ANCHOR.TOP, line_spacing=1.0,
             wrap=True):
    tb = s.shapes.add_textbox(x, y, w, h)
    tf = tb.text_frame
    tf.word_wrap = wrap
    tf.vertical_anchor = anchor
    tf.margin_left = 0
    tf.margin_right = 0
    tf.margin_top = 0
    tf.margin_bottom = 0
    lines = text.split("\n")
    for i, line in enumerate(lines):
        p = tf.paragraphs[0] if i == 0 else tf.add_paragraph()
        p.text = line
        p.alignment = align
        p.line_spacing = line_spacing
        r = p.runs[0]
        r.font.size = Pt(size)
        r.font.color.rgb = color
        r.font.bold = bold
        r.font.italic = italic
        r.font.name = font
    return tb


def add_bullets(s, x, y, w, h, items, size=15, color=TEXT_DARK, font="Calibri",
                 space_after=10, marker_color=GOLD, bold_lead=True, line_spacing=1.08):
    """items: list of (lead, rest) or plain strings, or (lead, rest, sub_level_bool)"""
    tb = s.shapes.add_textbox(x, y, w, h)
    tf = tb.text_frame
    tf.word_wrap = True
    tf.margin_left = 0
    tf.margin_right = 0
    tf.margin_top = 0
    tf.margin_bottom = 0
    first = True
    for item in items:
        sub = False
        if isinstance(item, tuple):
            if len(item) == 3:
                lead, rest, sub = item
            else:
                lead, rest = item
        else:
            lead, rest = "", item
        p = tf.paragraphs[0] if first else tf.add_paragraph()
        first = False
        p.alignment = PP_ALIGN.LEFT
        p.space_after = Pt(space_after)
        p.line_spacing = line_spacing
        indent = "      " if sub else ""
        bullet_char = "\u2013" if sub else "\u25AA"
        r0 = p.add_run()
        r0.text = f"{indent}{bullet_char}  "
        r0.font.size = Pt(size - (2 if sub else 0))
        r0.font.color.rgb = marker_color if not sub else TEXT_MUTE
        r0.font.name = font
        r0.font.bold = True
        if lead:
            r1 = p.add_run()
            r1.text = lead
            r1.font.size = Pt(size - (2 if sub else 0))
            r1.font.bold = bold_lead
            r1.font.color.rgb = NAVY if not sub else TEXT_MUTE
            r1.font.name = font
        r2 = p.add_run()
        r2.text = rest
        r2.font.size = Pt(size - (2 if sub else 0))
        r2.font.bold = False
        r2.font.color.rgb = color if not sub else TEXT_MUTE
        r2.font.name = font
    return tb


def header(s, kicker, title, num, total=13):
    add_rect(s, 0, 0, SLIDE_W, Inches(1.15), NAVY)
    add_rect(s, 0, Inches(1.15), SLIDE_W, Pt(3), GOLD)
    add_text(s, Inches(0.55), Inches(0.12), Inches(10.5), Inches(0.35), kicker.upper(),
              size=12.5, color=GOLD, bold=True, font="Calibri", align=PP_ALIGN.LEFT)
    add_text(s, Inches(0.55), Inches(0.44), Inches(11.5), Inches(0.68), title,
              size=27, color=WHITE, bold=True, font="Georgia", align=PP_ALIGN.LEFT)
    add_text(s, Inches(12.35), Inches(0.42), Inches(0.7), Inches(0.4), f"{num:02d}",
              size=16, color=GOLD, bold=True, font="Georgia", align=PP_ALIGN.RIGHT)
    footer(s, num, total)


def footer(s, num, total=13):
    add_text(s, Inches(0.55), Inches(7.14), Inches(6), Inches(0.3),
              "Historical Aspects of Hernia", size=9.5, color=TEXT_MUTE, font="Calibri")
    add_text(s, Inches(11.6), Inches(7.14), Inches(1.2), Inches(0.3),
              f"{num} / {total}", size=9.5, color=TEXT_MUTE, font="Calibri", align=PP_ALIGN.RIGHT)


def year_tag(s, x, y, text, w=Inches(1.5)):
    tag = add_rect(s, x, y, w, Inches(0.42), NAVY)
    tf = tag.text_frame
    tf.margin_left = 0; tf.margin_right = 0; tf.margin_top = 0; tf.margin_bottom = 0
    tf.vertical_anchor = MSO_ANCHOR.MIDDLE
    p = tf.paragraphs[0]
    p.alignment = PP_ALIGN.CENTER
    r = p.add_run(); r.text = text
    r.font.size = Pt(14); r.font.bold = True; r.font.color.rgb = GOLD; r.font.name = "Georgia"
    return tag


TOTAL = 13

# ============================================================ SLIDE 1: TITLE
s = add_slide(NAVY)
add_rect(s, 0, Inches(6.55), SLIDE_W, Inches(0.02), GOLD)
add_rect(s, Inches(0.9), Inches(2.35), Inches(0.06), Inches(2.15), GOLD)
add_text(s, Inches(1.25), Inches(2.15), Inches(11), Inches(0.5), "A SURGICAL HERITAGE",
          size=16, color=GOLD, bold=True, font="Calibri")
add_text(s, Inches(1.2), Inches(2.65), Inches(11.5), Inches(1.6),
          "Historical Aspects of Hernia", size=48, color=WHITE, bold=True, font="Georgia")
add_text(s, Inches(1.25), Inches(3.85), Inches(10.5), Inches(0.6),
          "From ancient Egyptian papyri to robotic surgery: the evolution of\ninguinal hernia repair",
          size=17, color=CREAM, italic=True, font="Georgia", line_spacing=1.15)
add_text(s, Inches(1.25), Inches(6.75), Inches(9), Inches(0.4),
          "Source: The History of Inguinal Hernia Surgery  |  General Surgery Compendium",
          size=11, color=RGBColor(0x9A,0xA7,0xB8), font="Calibri")

# ============================================================ SLIDE 2: OVERVIEW / DEFINITION
s = add_slide()
header(s, "Introduction", "What Is a Hernia, and Why History Matters", 2, TOTAL)
add_text(s, Inches(0.55), Inches(1.55), Inches(6.1), Inches(2.6),
          "A hernia is a protrusion of a viscus, or part of a viscus, through an "
          "abnormal opening in the walls of its containing cavity \u2014 most commonly "
          "the weakened fibromuscular tissue of the abdominal wall.",
          size=15.5, color=TEXT_DARK, font="Georgia", line_spacing=1.3)
add_bullets(s, Inches(0.55), Inches(3.35), Inches(6.2), Inches(3.2), [
    ("Ancient affliction: ", "hernias are among the oldest recorded human ailments, described millennia before modern medicine."),
    ("Most common operation: ", "inguinal hernia repair remains the most frequently performed general-surgery procedure worldwide."),
    ("An evolving craft: ", "despite its long history, technique continues to change \u2014 from trusses, to tissue repair, to tension-free mesh, to minimally invasive and robotic surgery."),
], size=15)
add_rect(s, Inches(7.1), Inches(1.55), Inches(5.7), Inches(4.95), NAVY)
add_text(s, Inches(7.4), Inches(1.8), Inches(5.1), Inches(0.4), "WHY STUDY THE HISTORY?", size=13, color=GOLD, bold=True, font="Calibri")
add_bullets(s, Inches(7.4), Inches(2.35), Inches(5.15), Inches(4.0), [
    ("", "Explains WHY current techniques (Bassini, Shouldice, Lichtenstein, laparoscopic) look the way they do"),
    ("", "Anatomical discoveries directly shaped surgical outcomes and recurrence rates"),
    ("", "Highlights a centuries-long, international collaboration of anatomists and surgeons"),
    ("", "Frames today's mesh and minimally-invasive era as the latest chapter, not the final one"),
], size=14.5, color=CREAM, marker_color=GOLD)

# ============================================================ SLIDE 3: ANCIENT ERA
s = add_slide()
header(s, "Antiquity", "The Ancient Era (c. 1500 BC \u2013 1st Century AD)", 3, TOTAL)
year_tag(s, Inches(0.55), Inches(1.55), "c.1550 BC")
add_text(s, Inches(2.25), Inches(1.55), Inches(10), Inches(0.5),
          "Earliest written record: the Egyptian Ebers Papyrus", size=17, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(2.2), Inches(11.9), Inches(0.9), [
    ("", "Physicians reduced the hernia (pushed it back in) and applied heat/cautery to the hernia sac \u2014 the first documented intervention for a groin hernia."),
], size=15)

year_tag(s, Inches(0.55), Inches(3.25), "Antiquity")
add_text(s, Inches(2.25), Inches(3.25), Inches(10), Inches(0.5),
          "Management by truss and bandage", size=17, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(3.9), Inches(11.9), Inches(0.9), [
    ("", "For centuries, hernias were treated non-operatively with external trusses, bandages, and dressings rather than surgery."),
], size=15)

year_tag(s, Inches(0.55), Inches(4.95), "1st c. AD")
add_text(s, Inches(2.25), Inches(4.95), Inches(10), Inches(0.5),
          "First operative repairs \u2014 Celsus and the Greco-Roman surgeons", size=17, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(5.6), Inches(11.9), Inches(1.4), [
    ("", "The first evidence of operative groin-hernia repair dates to the 1st century AD."),
    ("", "Early operations used wide scrotal incisions and typically required orchiectomy (removal of the testis) on the affected side \u2014 a radical, high-morbidity solution by modern standards."),
], size=15)

# ============================================================ SLIDE 4: MEDIEVAL ERA
s = add_slide()
header(s, "Medieval Period", "Medieval Refinements (c. 700 \u2013 1500 AD)", 4, TOTAL)
year_tag(s, Inches(0.55), Inches(1.7), "c.700 AD")
add_text(s, Inches(2.25), Inches(1.7), Inches(10), Inches(0.5),
          "Mass ligation and en bloc excision", size=17, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(2.35), Inches(11.9), Inches(1.2), [
    ("", "Surgical principle shifted toward mass ligation and en bloc excision of the hernia sac, spermatic cord, and testis distal to the external ring \u2014 a more systematic (if still radical) approach."),
], size=15)

year_tag(s, Inches(0.55), Inches(3.65), "14th c.")
add_text(s, Inches(2.25), Inches(3.65), Inches(10), Inches(0.5),
          "The first anatomical classification of groin hernias", size=17, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(4.3), Inches(11.9), Inches(1.3), [
    ("", "First reports classify groin hernias by the anatomy of the defect \u2014 distinguishing inguinal from femoral hernias \u2014 laying the groundwork for precise diagnosis centuries later."),
], size=15)
add_rect(s, Inches(0.55), Inches(5.85), Inches(11.9), Inches(1.0), CREAM, line=True)
add_text(s, Inches(0.8), Inches(6.0), Inches(11.4), Inches(0.7),
          "Note: throughout antiquity and the medieval period, surgery for hernia was dangerous, disfiguring, "
          "and reserved largely for incarcerated or strangulated cases \u2014 elective repair barely existed.",
          size=13, italic=True, color=TEXT_MUTE, font="Georgia")

# ============================================================ SLIDE 5: AGE OF DISSECTION
s = add_slide()
header(s, "16th\u201318th Century", "The Age of Dissection: Anatomy Unlocks Surgery", 5, TOTAL)
add_text(s, Inches(0.55), Inches(1.45), Inches(11.9), Inches(0.5),
          "Renaissance and Enlightenment anatomists dissected the groin region, giving surgeons the roadmap "
          "they needed to operate safely.", size=14.5, italic=True, color=TEXT_MUTE, font="Georgia")

names = [
    ("1559", "Caspar Stromayr", "First classification of inguinal hernias as direct or indirect"),
    ("G. Falloppio", "1523\u20131562", "Described the inguinal ligament and its role in the region's anatomy"),
    ("F. Poupart", "1661\u20131709", "Poupart's ligament (the inguinal ligament)"),
    ("P. Camper", "1722\u20131789", "Camper's fascia"),
    ("A. Scarpa", "1752\u20131832", "Scarpa's fascia"),
    ("A. de Gimbernat", "1734\u20131790", "Gimbernat's (lacunar) ligament; new method for crural/femoral hernia"),
]
# grid of 6 cards, 3 columns x 2 rows
cols = 3
card_w = Inches(3.85); card_h = Inches(1.95)
gap_x = Inches(0.22); gap_y = Inches(0.2)
start_x = Inches(0.55); start_y = Inches(2.1)
cards = [
    ("1559 \u2014 Caspar Stromayr", "First classification of inguinal hernias as direct (through the abdominal wall) or indirect (through the internal ring)."),
    ("G. Falloppio (1523\u20131562)", "Emphasized the inguinal ligament's importance to groin anatomy and hernia etiology."),
    ("F. Poupart (1661\u20131709)", "Described Poupart's ligament \u2014 the inguinal ligament, a key surgical landmark."),
    ("P. Camper (1722\u20131789)", "Described Camper's fascia, a superficial fatty layer of the abdominal wall."),
    ("A. Scarpa (1752\u20131832)", "Described Scarpa's fascia, the deeper membranous layer overlying the inguinal region."),
    ("A. de Gimbernat (1734\u20131790)", "Discovered Gimbernat's (lacunar) ligament; devised a new method for crural (femoral) hernia repair (1793) that reduced fatal hemorrhage."),
]
for i, (t, d) in enumerate(cards):
    r = i // cols
    c = i % cols
    x = start_x + c * (card_w + gap_x)
    y = start_y + r * (card_h + gap_y)
    card = add_rect(s, x, y, card_w, card_h, WHITE, line=True)
    card.line.color.rgb = RGBColor(0xD8,0xCF,0xBC)
    card.line.width = Pt(0.75)
    add_rect(s, x, y, Inches(0.09), card_h, GOLD)
    add_text(s, x + Inches(0.28), y + Inches(0.14), card_w - Inches(0.45), Inches(0.5),
              t, size=13.5, bold=True, color=NAVY, font="Georgia")
    add_text(s, x + Inches(0.28), y + Inches(0.62), card_w - Inches(0.45), Inches(1.25),
              d, size=12, color=TEXT_DARK, font="Calibri", line_spacing=1.15)

# ============================================================ SLIDE 6: FIRST SURGICAL SUCCESSES
s = add_slide()
header(s, "17th\u201318th Century", "The First Deliberate Surgical Repairs", 6, TOTAL)
year_tag(s, Inches(0.55), Inches(1.6), "1716")
add_text(s, Inches(2.25), Inches(1.6), Inches(10), Inches(0.5),
          "Demetrius Cantemir performs the first true surgical hernia repair", size=16.5, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(2.25), Inches(11.9), Inches(1.0), [
    ("", "The first surgical inguinal hernia repair via an open, transabdominal (laparotomy) approach \u2014 a deliberate operative cure rather than emergency excision."),
], size=14.5)

year_tag(s, Inches(0.55), Inches(3.35), "1735")
add_text(s, Inches(2.25), Inches(3.35), Inches(10), Inches(0.5),
          "Claudius Amyand describes \u201cAmyand's hernia\u201d", size=16.5, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(4.0), Inches(11.9), Inches(1.0), [
    ("", "First recorded successful appendectomy, performed through a hernia sac containing a perforated appendix \u2014 the eponym persists today for this rare presentation."),
], size=14.5)

year_tag(s, Inches(0.55), Inches(5.1), "L. Heister")
add_text(s, Inches(2.25), Inches(5.1), Inches(10), Inches(0.5),
          "Heister performs bowel resection for strangulated hernia (1683\u20131758)", size=16.5, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(5.75), Inches(11.9), Inches(1.1), [
    ("", "Demonstrated that bowel compromised by a strangulated hernia could be resected \u2014 expanding surgery beyond simple reduction toward true emergency management."),
], size=14.5)

# ============================================================ SLIDE 7: BASSINI ERA
s = add_slide()
header(s, "1880s \u2014 Turning Point", "Bassini and the Birth of Modern Herniorrhaphy", 7, TOTAL)
add_rect(s, Inches(0.55), Inches(1.5), Inches(6.6), Inches(5.35), NAVY)
add_text(s, Inches(0.85), Inches(1.7), Inches(6.0), Inches(0.5), "EDOARDO BASSINI (1844\u20131924)", size=14, bold=True, color=GOLD, font="Calibri")
add_bullets(s, Inches(0.85), Inches(2.25), Inches(6.0), Inches(4.4), [
    ("First performed: ", "1884; initial results published 1889."),
    ("Technique: ", "high ligation of the hernia sac at the internal ring plus suture reinforcement of the posterior inguinal wall \u2014 uniting the transversalis fascia to the inguinal ligament."),
    ("Results: ", "100% follow-up over 5 years, with only 5 recurrences among 250+ patients \u2014 an outcome unheard of at the time."),
    ("Legacy: ", "ended the era of crude excisional surgery and launched modern tissue-based herniorrhaphy; more than 150 later modifications trace back to his method."),
], size=14, color=CREAM, marker_color=GOLD)

add_text(s, Inches(7.5), Inches(1.55), Inches(5.3), Inches(0.4), "BUILDING ON BASSINI", size=13, bold=True, color=NAVY, font="Calibri")
add_bullets(s, Inches(7.5), Inches(2.05), Inches(5.35), Inches(4.7), [
    ("1898 \u2014 Lotheissen: ", "introduced the first true Cooper's-ligament repair, fixing the pectineal (Cooper's) ligament to the inguinal ligament to treat both inguinal and femoral defects."),
    ("McVay: ", "popularized and refined the Cooper's-ligament repair, adding a relaxing incision to reduce wound tension."),
    ("Late 1800s \u2014 Marcy, Kocher, Lucas-Champonni\u00e8re: ", "applied the new principles of aseptic technique to sac dissection and high ligation, improving safety even before Bassini's refinements spread widely."),
], size=13.5)

# ============================================================ SLIDE 8: TISSUE REPAIR REFINED + PEDIATRIC
s = add_slide()
header(s, "1900s\u20131950s", "Refining Tissue Repair \u2014 and Hernias in Children", 8, TOTAL)
add_text(s, Inches(0.55), Inches(1.5), Inches(5.9), Inches(0.4), "THE SHOULDICE TECHNIQUE", size=14, bold=True, color=NAVY, font="Calibri")
year_tag(s, Inches(0.55), Inches(1.95), "1958", w=Inches(1.2))
add_bullets(s, Inches(1.95), Inches(1.9), Inches(4.55), Inches(2.4), [
    ("", "A meticulous modification of Bassini's operation, closing the inguinal floor in four distinct layers."),
    ("", "Associated with excellent long-term outcomes and recurrence rates under 1% in expert hands \u2014 though technically demanding to master."),
], size=13.5)

add_text(s, Inches(6.9), Inches(1.5), Inches(5.9), Inches(0.4), "PEDIATRIC HERNIA REPAIR", size=14, bold=True, color=NAVY, font="Calibri")
add_bullets(s, Inches(6.9), Inches(1.95), Inches(5.9), Inches(3.9), [
    ("1912/1914 \u2014 Turner, MacLennan: ", "advocated simple removal of the sac through a very small incision in children."),
    ("1925 \u2014 Robert Hamilton Russell: ", "emphasized that in infants and children, ligation and removal of the sac alone (without floor repair) is sufficient."),
    ("1938 \u2014 Gertrude Herzfeld: ", "used a small inguinal-ring incision, ligated the sac, and closed the ring with a single stitch \u2014 an early minimalist pediatric technique."),
    ("1945 \u2014 Jerome Coles: ", "advised high transfixion and ligation of the sac's proximal end."),
], size=13)

add_rect(s, Inches(0.55), Inches(4.5), Inches(5.9), Inches(2.35), CREAM, line=True)
add_text(s, Inches(0.8), Inches(4.65), Inches(5.4), Inches(0.4), "OTHER APPROACHES", size=13, bold=True, color=NAVY, font="Calibri")
add_bullets(s, Inches(0.8), Inches(5.05), Inches(5.45), Inches(1.7), [
    ("1919 \u2014 La Roque: ", "combined abdominal and cutaneous incisions to ligate a retracted sac."),
    ("1920 \u2014 Cheatle: ", "first totally extraperitoneal, lower mid-abdominal preperitoneal approach for inguinal and femoral hernias."),
    ("1936 \u2014 Arnold Henry: ", "devised a lower midline preperitoneal approach."),
], size=12.5)

# ============================================================ SLIDE 9: MYOPECTINEAL ORIFICE
s = add_slide()
header(s, "Anatomical Insight", "The Myopectineal Orifice: Rethinking the Groin", 9, TOTAL)
add_text(s, Inches(0.55), Inches(1.6), Inches(11.9), Inches(0.7),
          "A pivotal conceptual shift moved surgeons from thinking of the groin as isolated defects to "
          "understanding it as a single weak anatomical region.", size=15, italic=True, color=TEXT_MUTE, font="Georgia")

add_rect(s, Inches(0.55), Inches(2.5), Inches(5.85), Inches(4.3), WHITE, line=True)
add_rect(s, Inches(0.55), Inches(2.5), Inches(5.85), Inches(0.08), GOLD)
add_text(s, Inches(0.9), Inches(2.75), Inches(5.2), Inches(0.5), "Henri Fruchaud", size=18, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.9), Inches(3.35), Inches(5.2), Inches(3.3), [
    ("", "First described the \u201cmyopectineal orifice\u201d \u2014 a single musculo-aponeurotic gap bounded by muscle above and the pectineal (Cooper's) ligament below."),
    ("", "Through this orifice pass all inguinal AND femoral hernias, reframing them as variants of one anatomical weakness rather than separate diseases."),
    ("", "This concept underlies why a single large mesh (as used in laparoscopic TAPP/TEP and Stoppa repairs) can cover and prevent all groin hernia types at once."),
], size=13.5)

add_rect(s, Inches(6.6), Inches(2.5), Inches(6.2), Inches(4.3), WHITE, line=True)
add_rect(s, Inches(6.6), Inches(2.5), Inches(6.2), Inches(0.08), GOLD)
add_text(s, Inches(6.95), Inches(2.75), Inches(5.6), Inches(0.5), "Raymond Read", size=18, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(6.95), Inches(3.35), Inches(5.6), Inches(3.3), [
    ("", "Emphasized the pathophysiology of the inguinal region \u2014 changes in collagen metabolism and connective-tissue integrity \u2014 rather than viewing hernia as simply a mechanical hole."),
    ("", "Helped explain why hernias recur, why they cluster with other connective-tissue conditions, and why reinforcement (not just closure) is often required."),
    ("", "Together with Fruchaud, this work laid the scientific foundation for the tension-free, mesh-based repairs that followed."),
], size=13.5)

# ============================================================ SLIDE 10: MESH REVOLUTION
s = add_slide()
header(s, "1950s\u20131980s", "The Prosthetic Mesh Revolution", 10, TOTAL)
year_tag(s, Inches(0.55), Inches(1.6), "1958\u201361")
add_text(s, Inches(2.25), Inches(1.6), Inches(10), Inches(0.5),
          "Francis Usher introduces polypropylene mesh", size=17, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(2.25), Inches(11.9), Inches(1.0), [
    ("", "Pioneered the use of synthetic (polypropylene / Marlex) mesh to reinforce hernia repairs, opening the door to tension-reducing prosthetic reinforcement."),
], size=14.5)

year_tag(s, Inches(0.55), Inches(3.35), "1960s")
add_text(s, Inches(2.25), Inches(3.35), Inches(10), Inches(0.5),
          "Richard Newman performs over 1,600 mesh repairs", size=17, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(4.0), Inches(11.9), Inches(0.9), [
    ("", "Demonstrated the durability and reproducibility of polypropylene mesh repair at scale, well before it became mainstream."),
], size=14.5)

year_tag(s, Inches(0.55), Inches(5.0), "1984\u201387")
add_text(s, Inches(2.25), Inches(5.0), Inches(10), Inches(0.5),
          "Irving Lichtenstein popularizes the \u201ctension-free\u201d mesh repair", size=17, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(5.65), Inches(11.9), Inches(1.55), [
    ("", "1987: published outcomes on 6,321 patients followed 2\u201314 years, with a recurrence rate of just 0.7% using a flat Marlex mesh placed without tension on the inguinal floor."),
    ("", "Unlike Bassini/Shouldice/McVay, no attempt is made to close the posterior wall under tension \u2014 the mesh alone bridges and reinforces the defect, with a markedly shorter learning curve."),
], size=14, marker_color=GOLD)

# ============================================================ SLIDE 11: MINIMALLY INVASIVE ERA
s = add_slide()
header(s, "1980s\u2013Present", "The Minimally Invasive and Robotic Era", 11, TOTAL)
year_tag(s, Inches(0.55), Inches(1.6), "1979\u201382")
add_text(s, Inches(2.25), Inches(1.6), Inches(10), Inches(0.5),
          "Ralph Ger describes the first laparoscopic hernia approach", size=17, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(2.25), Inches(11.9), Inches(0.9), [
    ("", "Closed the internal inguinal ring laparoscopically with clips \u2014 the conceptual origin of minimally invasive hernia surgery."),
], size=14.5)

year_tag(s, Inches(0.55), Inches(3.3), "1989\u201393")
add_text(s, Inches(2.25), Inches(3.3), Inches(10), Inches(0.5),
          "Mesh is introduced into laparoscopic repair; TAPP and TEP emerge", size=17, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(3.95), Inches(11.9), Inches(1.3), [
    ("", "Intraperitoneal onlay mesh (IPOM), transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) repairs are developed through the early-to-mid 1990s, applying Fruchaud's myopectineal-orifice concept with a single large mesh."),
], size=14.5)

year_tag(s, Inches(0.55), Inches(5.4), "1998")
add_text(s, Inches(2.25), Inches(5.4), Inches(10), Inches(0.5),
          "Large multicenter data confirm laparoscopic safety", size=17, bold=True, color=NAVY, font="Georgia")
add_bullets(s, Inches(0.55), Inches(6.0), Inches(11.9), Inches(1.1), [
    ("", "A multicenter study reported a 0.4% recurrence rate across 10,053 laparoscopic repairs, validating the technique; robotic-assisted inguinal hernia repair is the newest chapter, prized for ergonomics and visualization."),
], size=14)

# ============================================================ SLIDE 12: TIMELINE SUMMARY
s = add_slide(NAVY)
add_rect(s, 0, 0, SLIDE_W, Inches(1.15), NAVY_DARK)
add_rect(s, 0, Inches(1.15), SLIDE_W, Pt(3), GOLD)
add_text(s, Inches(0.55), Inches(0.12), Inches(10.5), Inches(0.35), "SUMMARY".upper(), size=12.5, color=GOLD, bold=True, font="Calibri")
add_text(s, Inches(0.55), Inches(0.44), Inches(11.5), Inches(0.68), "Milestones at a Glance", size=27, color=WHITE, bold=True, font="Georgia")
add_text(s, Inches(12.35), Inches(0.42), Inches(0.7), Inches(0.4), "12", size=16, color=GOLD, bold=True, font="Georgia", align=PP_ALIGN.RIGHT)

milestones = [
    ("1550 BC", "Ebers Papyrus \u2014 first documented hernia treatment (Egypt)"),
    ("1st c. AD", "First operative groin repairs (Greco-Roman surgery)"),
    ("1559", "Stromayr classifies direct vs. indirect inguinal hernia"),
    ("1716", "Cantemir performs the first true surgical repair"),
    ("1793", "Gimbernat's method for crural (femoral) hernia"),
    ("1887\u201389", "Bassini's tissue repair transforms outcomes"),
    ("1958", "Shouldice 4-layer repair \u2014 Usher's polypropylene mesh"),
    ("1984\u201387", "Lichtenstein's tension-free mesh repair"),
    ("1982\u201393", "Ger's laparoscopic approach \u2192 TAPP / TEP"),
    ("Today", "Robotic-assisted, mesh-based minimally invasive repair"),
]
# timeline as vertical line with alternating dot rows -> simpler: two columns list with connecting line
line_x = Inches(6.62)
add_rect(s, line_x, Inches(1.55), Pt(2.2), Inches(5.5), GOLD)
n = len(milestones)
top = 1.7
spacing = 5.3 / (n)
for i, (yr, desc) in enumerate(milestones):
    y = Inches(top + i * spacing)
    dot = s.shapes.add_shape(MSO_SHAPE.OVAL, line_x - Pt(4.5), y + Inches(0.06), Pt(11), Pt(11))
    dot.fill.solid(); dot.fill.fore_color.rgb = GOLD; no_line(dot)
    if i % 2 == 0:
        add_text(s, Inches(0.7), y, Inches(5.65), Inches(0.5), yr, size=13.5, bold=True, color=GOLD, font="Georgia", align=PP_ALIGN.RIGHT)
        add_text(s, Inches(0.7), y + Inches(0.28), Inches(5.65), Inches(0.5), desc, size=11.5, color=CREAM, font="Calibri", align=PP_ALIGN.RIGHT, line_spacing=1.05)
    else:
        add_text(s, Inches(6.95), y, Inches(5.7), Inches(0.5), yr, size=13.5, bold=True, color=GOLD, font="Georgia")
        add_text(s, Inches(6.95), y + Inches(0.28), Inches(5.7), Inches(0.5), desc, size=11.5, color=CREAM, font="Calibri", line_spacing=1.05)
footer(s, 12, TOTAL)

# ============================================================ SLIDE 13: CONCLUSION + SOURCES
s = add_slide()
header(s, "Conclusion", "Key Takeaways and Sources", 13, TOTAL)
add_text(s, Inches(0.55), Inches(1.5), Inches(6.0), Inches(0.4), "KEY TAKEAWAYS", size=14, bold=True, color=NAVY, font="Calibri")
add_bullets(s, Inches(0.55), Inches(2.0), Inches(6.0), Inches(4.4), [
    ("", "Hernia surgery evolved from crude excision and orchiectomy to precise, tissue-sparing, tension-free repair."),
    ("", "Anatomical discovery (Falloppio to Fruchaud) consistently preceded and enabled surgical progress."),
    ("", "Bassini (1887) and Lichtenstein (1987) mark the two great turning points in open repair, exactly a century apart."),
    ("", "The shift from tissue tension to prosthetic reinforcement, then to minimally invasive and robotic access, defines the last 70 years."),
    ("", "Understanding this history clarifies why modern guidelines favor mesh-based, tension-free, and laparo-endoscopic techniques."),
], size=13.5)

add_rect(s, Inches(6.95), Inches(1.5), Inches(5.85), Inches(5.35), CREAM, line=True)
add_text(s, Inches(7.25), Inches(1.7), Inches(5.3), Inches(0.4), "SOURCES", size=14, bold=True, color=NAVY, font="Calibri")
add_bullets(s, Inches(7.25), Inches(2.2), Inches(5.35), Inches(4.5), [
    ("", "Felix, E. & Rouse, R. \u201cThe History of Inguinal Hernia Surgery,\u201d General Surgery News (with commentary by Carbonell-Tatay & Murphy)."),
    ("", "\u201cFascinating History of Groin Hernias,\u201d World Journal of Clinical Cases / PMC8299909."),
    ("", "\u201cA Brief History of Hernia Surgery,\u201d Michigan Surgery / Dr. Scott Laker."),
    ("", "Xie et al. \u201cThe Evolution of Minimally Invasive Inguinal Hernia Repairs,\u201d Annals of Laparoscopic and Endoscopic Surgery."),
    ("", "Maingot's Abdominal Operations, Ch. \u201cInguinal Hernia\u201d \u2014 History section."),
    ("", "Schwartz's Principles of Surgery, 11th ed., Ch. \u201cInguinal Hernias\u201d \u2014 History section."),
], size=12.5, color=TEXT_DARK)

prs.save("/tmp/workspace/hernia_history_ppt/Historical_Aspects_of_Hernia.pptx")
print("Saved.")