Clifford Allbutt considered Franco the best lithotomist of the 16th century. His skill in extracting the stone by the perineal route was of a high order; in 1556 he introduced the operation of suprapubic cystotomy in operating for stone, which is recorded in the above. Franco also provided the first description of an operation for strangulated hernia. Franco, in 1556, was the first to perform suprapubic cystotomy. Poor, and largely self-taught, he greatly improved the technique of herniotomy.