Laparoscopic Repair of Umbilical and Paraumbilical Has the Lowest Rate of Recurrence

INTRODUCTION: No firm consensus currently exists on the best technique for the repair of umbilical and paraumbilical hernia in adults. The role of laparoscopic hernioplasty of umbilical hernia remains controversial,and a recent EAES consensus meeting recommended both open mesh, suture or laparoscopic repair for defects under 3cm.
METHODS: A retrospective audit was conducted and identified patients who had umbilical/paraumbilical hernia repairs performed over a ten year period, (January 1998- July 2008) (n=1200). Demographic data, hernia characteristics, complications and outcomes were recorded. Patients were divided into three groups based on operative technique, laparoscopic repair with mesh, open repair with mesh, and open repair without mesh (primary suture repair).
RESULTS: To date 212 cases have been evaluated. Age range was from 3-86 (mean 48). A total of 169 open cases were performed compared to 43 laparoscopic cases. Recurrence rates were 8.2% (n=14) in the open group compared to 2.3% (n=1) in the laparoscopic group (n.s Fisher’s exact test; Odds Ratio: 0.38 95% CI: 0.05-2.84). In the open group 12 recurrences were from primary suture repairs and 2 from mesh repairs (n.s Fisher’s exact test). Complications recorded included wound infection 4.1% (n=7) open vs 2.7% (n=3) laparoscopic, 1 wound dehiscence in the open group and 1 incisional hernia in the laparoscopic group. In the open group 3% (n=5) were associated with a hospital stay of greater than 24h compared to 4.6% (n=2) in the laparoscopic group.
CONCLUSIONS: In this series the laparoscopic repair of umbilical/paraumbilical hernias resulted in a trend to a lower recurrence rate and overall complication rate. Although not reaching significance open repair with simple suture had a higher recurrence rate than repairs with mesh. In this series laparoscopic repair of para/umbilical hernias had the lowest recurrence rate.

Session: Podium Presentation

Program Number: S021

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