Para Umbilical Hernias (original) (raw)
Related papers
Mesh repair versus mayo repair for paraumbilical hernia: a comparative study
International Surgery Journal
Background: Para umbilical hernia is a multifactorial and complex process they are most commonly found along the midline linea Alba. This study aims to assess the efficacy of mesh repair in comparison to Mayo Repair and to analyze the morbidity associated with the management.Methods: The study was conducted in Victoria Hospital and Bowring and Lady Curzon Hospital attached to Bangalore Medical College & Research Institute, with clinical features suggestive of Paraumbilical Hernia (Minimum 30 cases each) from October 2010 to September 2012. Pediatric age group and those patients requiring emergency surgery have been excluded. 30 patients underwent Mayo’s repair and 30 patients underwent Mesh repair. Follow up period ranged from 2 months to 24 months.Results: paraumbilical hernia was found more commonly between 4rd and 6th decade of life with female: male 2.3:1. Most common presenting symptom was swelling with cough impulse (36.5%) and reducibility present. Commonest predisposing fact...
Objectives: To compare the results of different repair methods (simple suture repair and mesh repair) in terms of morbidity, complications and relapses. Place and Duration: In the Surgical Unit-II of Sir Gang ram Hospital, Lahore for one-year duration from July 2019 to July 2020. Patients and Methods: Total number of patients were 50; they were all women divided into 2 groups. Group A consisted of 25 patients who had undergone a simple Mayo repair / simple repair. Group B consisted of 25 patients who underwent mesh repair. The most common early postoperative complication was wound seroma and wound infection. Chronic pain was observed more frequently in patients in group B, while the relapse rate was high in group A. Conclusion: The overall incidence was almost the same in both groups, but the relapse rate was high in group A. There was no mortality in the study.
BJS Open
Background: Chronic postoperative pain occurs in up to 21⋅7 per cent of patients undergoing open inguinal hernia repair. Several mesh fixation techniques using glue or self-gripping meshes have been developed to reduce postoperative pain. The aim of this meta-analysis was to evaluate RCTs comparing adhesional/self-gripping and sutured single-layer open mesh fixations in the repair of inguinal herniation, with postoperative pain as endpoint. Methods: PubMed, Embase and Cochrane CENTRAL databases were searched systematically for RCTs according to the PRISMA guidelines; the study was registered at PROSPERO (CRD42017056373). Different fixation methods were analysed. The primary outcome, chronic pain, was defined as a postoperative visual analogue scale (VAS) score of at least 3 at 12 months. Secondary outcomes were mean VAS score at 1 week and at 1 month after surgery. Results: Twenty-three studies including 5190 patients were included in the meta-analysis. Adhesional (self-adhering or glued) or self-gripping fixation methods were associated with a significantly lower VAS score at 1 week (mean difference-0⋅49, 95 per cent c.i.-0⋅81 to-0⋅17; P = 0⋅003) and at 1 month (mean difference-0⋅31,-0⋅58 to-0⋅04; P = 0⋅02) after surgery than suture fixation, but the incidence of chronic pain after 12 months was similar in the two groups (odds ratio 0⋅70, 95 per cent c.i. 0⋅30 to 1⋅66). Differences in recurrences and complications between groups did not reach statistical significance. Conclusion: There was no difference in the incidence of chronic pain 12 months after different mesh repair fixation techniques despite significant reductions in short-term postoperative pain favouring a non-sutured technique. There were no differences in recurrence rates or in rates of other complications at 1 year.
PARIPEX INDIAN JOURNAL OF RESEARCH, 2022
A hernia is defined as a protrusion, bulge, or projection of an organ or a part of an organ through the body wall that normally contains it. There is still very limited evidence regarding prevalence, particularly in low-income countries, but hernia repair is an extremely common general surgical procedure. The current hospital based prospective study was conducted among 102 patients, 51 participants enrolled in Mesh repair and 51 for Herniorrhaphy presenting to the Department of General Surgery at tertiary health care institute. with objectives to study the hernia repair with mesh versus without mesh. Outcomes like hernia recurrence, postoperative pain, duration of operation, postoperative hospital stay, time to return to activities of daily living & also to evaluate the benefits and complications of different inguinal hernia repair techniques in adults studied. Total 102 patients were considered between age group of 15 to 35 years for present study from Aug.2019 to Jan.2022,after applying inclusion and exclusion criteria. In each group 51 patients were operated. Majority of patients for mesh repair (70%) & tissue repair (60%) were belonged to 21-25 & 15-20 years of age group respectively. Mean operation time for tissue repair (41.8 4.6) was more as compare to mesh repair (39.7 4.3).Outcome like post-operative stay, post-operative pain, days required for return to daily basic activities were significantly more for tissue repair as compared to mesh repair. In case of post-operative pain scale majority of mesh group will have chronic pain compared with Tissue repair group. Hematoma & urinary retention were statistically more significant in tissue repair (p<0.05). Wound infections, seroma, recurrence, reduced testicular perfusion, reduced sperm count were more in mesh repair as compare to tissue repair out of that only seroma shows significant in mesh repair. Concluded that the tissue repairs does not use a mesh, this makes tissue repair cost effective. Postoperative pain is significantly less initially with Mesh repair but increased on day 7 and chronic pain is seen with mesh repair but is not significant statistically. Most of the complications between 2 groups are not statistically significant except for seroma significant in mesh repair,hematoma and urinary retention significant in tissue repair.
American journal of surgery, 2016
The Patient-Reported Outcomes Measurement Information System was used to evaluate the effects of open incisional ventral hernia repair on hernia-related pain. All patients who underwent elective repair of a primary or recurrent midline incisional hernia over a 3-year period completed Patient-Reported Outcomes Measurement Information System pain surveys and rated their pain intensity on a visual analogue scale. A retrospective review of these patients was performed. Seventy-seven patients underwent midline incisional ventral hernia repair and completed preoperative and postoperative surveys. Thirty-eight patients completed surveys at least 6 months after surgery. These patients demonstrated significant improvement in pain interference postoperatively (P < .05) but not in pain behavior. Patients with higher pain intensity scores preoperatively had greater improvements in pain behavior and pain interference postoperatively. Patients with incisional ventral hernias have improvement i...
Surgery, 2007
Open mesh or non-mesh inguinal hernia repair may influence the incidence of chronic postoperative pain differently. Methods. A total of 300 patients scheduled for repair of a primary unilateral inguinal hernia were randomized to non-mesh or mesh repair. The primary outcome measure was clinical outcome including persistent pain and discomfort interfering with daily activity. Long-term results at 3 years of follow-up have been published. Included here are 10-year follow-up results with respect to pain.
Langenbeck's Archives of Surgery, 2011
Background Early post-operative pain after inguinal hernia repair delays management in ambulatory setting. The type of mesh used for repair appears to influence their incidence. Aims The aim of this randomized, prospective study using the alternation principle was to compare post-operative early pain and the quality of life of patients operated on for inguinal hernia depending on the type of mesh used and their impact on management in ambulatory setting. Patients and methods Fifty successive patients were included prospectively. Hernia repair was performed using the Lichtenstein procedure with two types of mesh, namely standard polypropylene 100 g/m 2 (Prolène®) or light polypropylene (55 g/m 2 ) with a natural beta-D-glucan coating (Glucamesh®). The main assessment criterion was post-operative pain evaluated twice daily by the patient for 7 days, using the visual analogue scale (VAS) and their use of analgesics. The secondary assessment criteria were the rate of unscheduled admissions the evening of the intervention and the hospital length of stay and the quality of life evaluated by the SF12 questionnaire at pre-operative stage and on days 7 and 30. Results The two groups were comparable. The operative durations were identical (38.8±10.2 vs 48±15.4 min). On the evening of the intervention before discharge, the pain was less intense in the Glucamesh® group (mean VAS score 21.6±2.4 vs 31.7±6.2, p=0.02). On day 4, 20% of patients from the Glucamesh® group and none of the patients from the Prolène® group had a VAS score of 0 (p=0.02). There were no unscheduled admissions in either group, but the hospital stay was significantly shorter in the Glucamesh® group compared with the Prolène® group (288±35 vs 360±48 min, p=0.02). The post-operative quality of life evaluated by the SF12 questionnaire from day 7 to day 30 was the same in both groups (38±4.8 vs 37±5.2) and altered as at pre-operative stage compared with a control population (normal=50). Conclusions This randomized, prospective study showed that the use of a self-adhesive, light mesh, reducing the fixation sutures and coated with factors favouring tissue integration, such as the Glucamesh® prosthesis, significantly reduced early post-operative pain compared with conventional prostheses and could increase the percentage of patients likely to undergo an ambulatory hernia repair.
A Study on Laparoscopic Mesh Repair of Paraumblical Hernia
Aim & Objectives: The main objective was to study the safety and complications of laparoscopic PUH repair, to assess the pain in postoperative period, to highlight the early return to normal activity and to evaluate for the recurrence of the hernia. Methods & Material: The period of study was from January 1 st 2012 to December 31 st 2016 at St. Martha's Hospital. A total of 26 patients between 22-70 years of age who were diagnosed to have para-umbilical hernia was taken into study. Results: All the 26 patients underwent laparoscopic mesh repair without conversion. Dual mesh (PTFE) was the commonly used mesh with a mean operating time of 128 minutes. There was no intra operative complication. Seroma was found to be the most common post operative complication (15.4%). In the prospective study, 8 patients were evaluated for post operative pain and found that 62.5% had no pain on second postoperative day. The mean postoperative hospital stay was 2.4 days and the mean time taken for return to normal activity was 7 days. There was only one recurrence (3.8%) seen at the follow up period of 48 months. All the patients were cosmetically satisfied. Conclusion: The following conclusions were made during the course of study: Paraumbilical hernia is more common between the 3 rd and 5 th decade of life. 1) Women are affected more frequently than men. 2) Laparoscopic paraumbilical hernia mesh repair is an effective and safe procedure with minimal postoperative complications. 3) Seroma being the most common postoperative complication. 4) Patients have a shorter postoperative hospital stay. 5) Postoperatively, pain is minimal and patients return to their normal activity earlier. 6) The recurrence rate is low (3.8%) and cosmetically better as no umbilectomy or drainage is done.