Concomitant Abdominoplasty and Laparoscopic Umbilical Hernia Repair (original) (raw)
Related papers
Retro rectus mesh repair for umbilical hernia in adults: a study of 50 cases
International Surgery Journal
Background: Umbilical hernia is one of the most commonly encountered hernia in surgical practice. A variety of repairs have been tried our ranging from open to laparoscopic. However controversy still persists as to which type of repair is the gold standard for umbilical hernia. Open technique comprises of the onlay mesh repair which is known to develop a variety of complications. Even laparoscopic approach also has failure rates as well as local complications. The aim of the study was to evaluate the surgical outcome of open retro rectus mesh repair for adult umbilical hernias.Methods: 50 consecutive cases of umbilical hernia were repaired by open technique with retro rectus placement of mesh.Results: There were no local complications or any recurrence in any of the fifty patients.Conclusions: Retro rectus placement of mesh in open repair of umbilical hernia in adults is a safe and effective modality of treatment.
A clinical study of laparoscopic versus open umbilical hernia repair
Surgical Update: International Journal of Surgery and Orthopedics
Background: Umbilical Hernia is one of the most common surgical problems. Since the prosthetic repair has become the standard of practice for inguinal hernia management, the same has been adapted for Umbilical hernia management with better outcome. There is still debate going on regarding the better surgical approach. There are very few prospective studies comparing the laparoscopic and open method of Umbilical hernia mesh repair. This study compared the short term outcomes following laparoscopic versus open mesh repair of Umbilical hernia. Methods: Patients who underwent Umbilical hernia repair at Victoria hospital, Bengaluru between July 2015 to January 2017 were studied. Patients were divided into two groups, those who underwent Laparoscopic repair were considered into "group A" and those who underwent Open repair were considered into "group B". Both the groups were compared with respect to Duration of surgery, Use of Drains, complications like wound infection, seroma, and haematoma, Return to normal activity, Duration of hospital stay.Results:A total of 96 patients underwent umbilical hernia repair out of which 88 were included as 8 patients underwent primary suture repairs. Out of 88 patients 49(55.68%) patients underwent Laparoscopic mesh repair [Group A] and 39 (44.32%) patients underwent open mesh repair. Duration of surgery is relatively less in Group B, Use of Drains, Complications like wound infection, seroma and haematoma is significantly less in Group A, Duration of hospital stay is relatively less in Group A, Return to normal activity is faster in Group A. Conclusion: Laparoscopic umbilical hernia repair is a safe and effective technique. Laparoscopic mesh repair required in shorter duration of surgery, less use of postoperative drains, faster return to normal activity and less complications rate, shorter hospital stay.
Single-Port Repair of Diastasis Recti and Umbilical Hernia Combined with Abdominoplasty
CRSLS: MIS Case Reports from SLS, 2014
Introduction: Evidence-based treatment of abdominal hernias involves the use of prosthetic mesh. However, the most commonly used method of treatment of diastasis of the recti involves plication with non-absorbable sutures as part of an abdominoplasty procedure. This case report describes single-port laparoscopic repair of diastasis of recti and umbilical hernia with prosthetic mesh after plication with slowly absorbable sutures combined with abdominoplasty. Technique Description: Our patient is a 36-year-old woman with severe diastasis of the recti, umbilical hernia and an excessive amount of redundant skin after two previous pregnancies and caesarean sections. After raising the upper abdominal flap, a single-port was placed in the left upper quadrant and the ligamenturn teres was divided. The diastasis of the recti and umbilical hernia were plicated under direct vision with continuous and interrupted slowly absorbable sutures before an antiadhesive mesh was placed behind the repair with 6 cm overlap, transfixed in 4 quadrants and tacked in place with non-absorbable tacks in a double-crown technique. The left upper quadrant wound was closed with slowly absorbable sutures. The excess skin was removed and fibrin sealant was sprayed in the subcutaneous space to minimize the risk of serorna formation without using drains. Discussion: Combining single-port laparoscopic repair of diastasis of recti and umbilical hemia repair minimizes inadvertent suturing of abdominal contents during plication, the risks of port site hernias associated with conventional multipart repair and permanently reinforced the midline weakness while achieving "scarless" surgery.
Retrospective comparison of mesh and sutured repair for adult umbilical hernias
Hernia, 2005
Adult umbilical and paraumbilical hernia repair is associated with a high recurrence rate of 10-30%. Mesh repair has been reported to be associated with low recurrence rates. This study aims to compare sutured repair with prosthetic mesh repair to evaluate recurrence and infection rates. A retrospective study was conducted over an 8-year period including all the umbilical and paraumbilical hernia repairs performed by one consultant surgeon. The hernias were repaired using interrupted suture, Mayo overlap, flat mesh and mesh plug techniques. The study was based on case-note review, telephone and postal questionnaire survey. A total of 100 patients were studied, of which 70 had paraumbilical hernias, 28 had umbilical hernias and 2 had both types of hernia. Median age was 56 years (range 19-90 years). A total of 61 patients had suture repair (50 interrupted suture repair, 11 Mayo) and 39 had prosthetic mesh repair (33 mesh plug, 6 flat mesh). The median body mass index (BMI) was 31.2 (range 23.4-44.5) in the suture repair group and 33.3 (range 24.1-59.1) in the mesh group, with no significant statistical difference in BMI between the two groups (P>0.05). Median follow-up was 4.5 years (range 1-8 years). Recurrence rates for the suture and mesh repair groups were 11.5 and 0%, respectively (P=0.007). Infection rates for the suture and mesh repair groups were 11.5 and 0%, respectively (P=0.007). Our data suggest that prosthetic mesh repair is ideal for managing primary and recurrent umbilical hernias in both obese and non-obese patients.
Hernia : the journal of hernias and abdominal wall surgery, 2005
Adult umbilical hernia is a common surgical condition mainly encountered in the fifth and sixth decade of life. Despite the high frequency of the umbilical hernia repair procedure, disappointingly high recurrence rates, up to 54% for simple suture repair, are reported. Since both mesh and suture techniques are used in our clinic we set out to investigate the respective recurrence rates and associated complications, retrospectively. Patients who were treated between January 1998 and December 2002 were identified from our hospital database and invited to attend the outpatient department for an extra follow-up, history taking and physical examination. The use of prosthetic material, occurrence of surgical site infection, body mass and height as well as recurrence were recorded at the time of this survey. In total, 131 consecutive patients underwent operative repair of an umbilical hernia. Twenty-eight percent of the patients were female (n = 37). In 12 patients (11%) umbilical hernia r...
Global Journal of Surgery
Objectives: to determine the outcome of ventral hernia repair during abdominoplasty and mesh-abdominoplasty regarding cosmesis, recurrence and post-operative complications. Subjects and Methods: The present retrospective study included 78 multiparous women with ventral hernia and abdominal wall deformity. Age ranged between 28 and 59 years with a mean of 41.37±11.18 years. Half of the patients suffered from episodes of colicky abdominal pain and 34 (43.6%) had chronic low back pain. Forty patients (with defect < 3cm) underwent standard abdominoplasty (Group 1) and 38 (with defect > 3cm) underwent mesh-abdominoplasty (Group 2), both after primary suture hernia repair and midline fascial plication. The follow-up period ranged from 22 months to 11 years with a mean of 62.5 months. Results: Both groups were comparable regarding their demographic and clinical parameters. Patients with abdominoplasty had significantly (p=0.0193) more para-umbilical hernias (PUHs) than those with mesh-abdominoplasty (80% vs 55.3%, respectively), but had less incisional or recurrent PUHs. All repaired hernias did not recur except for one patient in each group. No mortality or major complications were encountered. Wound complications occurred in 7 patients (17.5%) in Group 1 vs 10 (26.3%) in Group 2 (p=0.346). Recurrence of abdominal wall deformity and the need for a second refashioning procedure were significantly higher among patients who underwent abdominoplasty alone (p=0.011 and p=0.0139, respectively). Conclusions: (1) During abdominoplasty, ventral hernia repair and midline plication can be performed in defects <3 cm with no increase in hernia recurrence rate, (2) in patients with defects >3 cm, additional mesh reinforcement is indicated and (3) Prolene mesh-abdominoplasty for multiparous women with severe musculo-aponeurotic laxity and ventral hernia, yields lower recurrence of abdominal deformity and less refashioning procedures with minimal complications than abdominoplasty alone.
Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults
British Journal of Surgery, 2001
Background:Prosthetic repair has become the standard method for inguinal hernia and has excellent results. The question remains of whether the mesh technique could also improve results for umbilical defects.Prosthetic repair has become the standard method for inguinal hernia and has excellent results. The question remains of whether the mesh technique could also improve results for umbilical defects.Methods:The study was a randomized clinical trial comparing herniorrhaphy (primary suture) with hernioplasty (polypropylene mesh or plug) in 200 adult patients with a primary umbilical hernia. Patients at high anaesthetic risk (American Society of Anesthesiologists (ASA) grade IV) or those who needed emergency surgery were excluded. The mean postoperative follow-up was 64 months. The population studied included 118 women and 82 men with a mean age at presentation of 57 years. Some 173 patients were ASA grade I–II and 27 were ASA III. The anaesthetic technique of choice was local anaesthetic infiltration plus sedation (98 per cent).The study was a randomized clinical trial comparing herniorrhaphy (primary suture) with hernioplasty (polypropylene mesh or plug) in 200 adult patients with a primary umbilical hernia. Patients at high anaesthetic risk (American Society of Anesthesiologists (ASA) grade IV) or those who needed emergency surgery were excluded. The mean postoperative follow-up was 64 months. The population studied included 118 women and 82 men with a mean age at presentation of 57 years. Some 173 patients were ASA grade I–II and 27 were ASA III. The anaesthetic technique of choice was local anaesthetic infiltration plus sedation (98 per cent).Results:There were no significant anaesthetic complications or surgical deaths. The mean duration of surgery was greater for mesh than for suture repair (45 versus 38 min). Rates of early complications such as seroma, haematoma or wound infection were similar in the two groups. The hernia recurrence rate was higher after suture repair (11 per cent) than after mesh repair (1 per cent) (P = 0·0015).There were no significant anaesthetic complications or surgical deaths. The mean duration of surgery was greater for mesh than for suture repair (45 versus 38 min). Rates of early complications such as seroma, haematoma or wound infection were similar in the two groups. The hernia recurrence rate was higher after suture repair (11 per cent) than after mesh repair (1 per cent) (P = 0·0015).Conclusion:Prosthetic repair could become the standard treatment for primary umbilical hernia in adults. © 2001 British Journal of Surgery Society LtdProsthetic repair could become the standard treatment for primary umbilical hernia in adults. © 2001 British Journal of Surgery Society Ltd
2019
Öz Purpose: The aim of this study is to compare the outcomes in patients with umbilical hernia who underwent suture-only repair (primary suture repair and Mayo’s repair) to those with mesh (hernia repair with prolene or the Ventralex Hernia Patch (VHP) hernia repair). Materials and Methods: ASA 1 and ASA 2 patients who had no medical condition requiring surgical intervention other than umbilical hernia were included in this study.. Small hernias were repaired by suturing only while mesh repair was used for medium size and large hernias. Among parameters to be assessed were presence of comorbidities, hernia repair techniques, postoperative complications, and postoperative recurrence rates by repair techniques. Follow-up assessments including physical examinations and/or ultrasound studies were performed to evaluate potential recurrences and other complications. Results: A total of 153 patients were included in the study. The incidence of seroma formation was significantly higher in t...
Hernia, 2016
Purpose To compare recurrence and surgical complications following two dominating techniques: the use of suture and mesh in umbilical hernia repair. Methods 379 consecutive umbilical hernia repair procedures performed between 1 January 2005 and 14 March 2014 in a university setting were included. Gathering was made using International Classification of Diseases codes for both procedure and diagnosis. Each patient record was scrutinized with respect to 45 variables, and the results entered in a database. Results Exclusion \18 years-of-age (32), non-primary umbilical hernia (25), wrong diagnosis (7), concomitant major abdominal surgery (5), double registration (3) and pregnancy (1) left 306 patients eligible for analysis. Gender distribution was 97 women and 209 men. There was no difference between mesh and suture with regard to the primary outcome variable, cumulative recurrence rate, 8.4 %. Recurrence was both self-reported and found on clinical revisit and defined as recurrence when verified by a clinician and/or radiologist. Results presented as odds ratio (OR) with 95 % confidence interval (CI) show a significantly higher risk for recurrence in patients with a coexisting hernia OR 2.84, 95 % CI 1.24-6.48. Secondary outcome, postoperative surgical complication (n = 51 occurrences), included an array of postoperative surgical events commencing within 30 days after surgery. Complication rate was significantly higher in patients receiving mesh repair OR 6.63, 95 % CI 2.29-20.38. Conclusions Suture repair decreases the risk for surgical complications, especially infection without an increase in recurrence rate. The risk for recurrence is increased in patients with a history of another hernia.
Umbilical Hernia Factors Affecting Outcome
Journal of Evolution of Medical and Dental Sciences, 2016
Aim of this study is to compare the effectiveness of surgical technique-Mesh repair techniques versus anatomical repair techniques with respect to the parameters of complications and recurrence rate. MATERIALS AND METHODS A detailed clinical study of paraumbilical hernia treated with both Mesh repair and Anatomical repair was undertaken at Department of General Surgery from January 2015 to June 2016 at K.R. Hospital attached to Mysore Medical College and Research Institute. Sixty patients were randomly assigned to Group A-Mesh Repair and Group B-Anatomical (Mayo's Repair). The same group of patients were studied for incidence, clinical features, treatment and postoperative complications pertaining to study period. Pts with irreducibility and incarcerated hernia were excluded from the study. Median period of followup was eighteen months. RESULTS Paraumbilical hernia is more common between 3rd and 6th decade of life. It is more common in males 56.7% than in females. There is no difference in age distribution of cases between males and females. Most common presenting symptom is swelling around the umbilicus, which may or may not be associated with pain. Most common position was Supraumbilical (56.7%), post-op complications like wound infection occurred in 10% in mesh repair and 6.67% in anatomical repair. In long-term follow-up, the recurrence was higher in Mayo's suture repair (10%) compared to mesh repair (3.33%) in our studies. CONCLUSION This study concludes that mesh repair has low recurrence rate with minimum complications. Mesh repair is considered the best and more superior to anatomical repair in due consideration to recurrence; however, in certain circumstances anatomical repair holds good which is cheaper and simple procedure.