Abstract
Background: There is no consensus on the best technique for the repair of umbilical hernia in adults. The role of laparoscopic hernioplasty of umbilical hernia remains controversial. This study was undertaken to compare the outcomes of open and laparoscopic onlay patch repair of umbilical hernia in adults. Methods: From January 1996 to December 2002, 102 patients underwent elective repair of umbilical hernia. Operative techniques included Mayo repair (n = 43), laparoscopic onlay Gore-Tex patch hernioplasty (n = 26), suture herniorrhaphy (n = 24), and mesh hernioplasty (n = 9). Results: Demographic features and risk factors were similar among the four groups. The operative time of laparoscopic hernioplasty (median, 66 min) was significantly longer than those for patients who underwent Mayo repair (60 min) or sutured herniorrhaphy (50 min) (p < 0.05). None of the patients who underwent laparoscopic patch repairs required conversion to open repair. The median pain score at rest on postoperative day 1 was significantly lower in patients who underwent laparoscopic repair compared to those who had Mayo repair. A significantly shorter hospital stay and a lower wound morbidity rate were also observed in patients who underwent laparoscopic repair. With a mean follow-up of 2 years, suture herniorrhaphy had a relatively high recurrence rate (8.7%), whereas no recurrence was documented for the other techniques. Conclusions: Laparoscopic onlay patch hernioplasty is a safe and efficacious technique for the repair of umbilical hernia. Compared to Mayo repair, the laparoscopic approach confers the advantages of reduced postoperative pain, shorter hospital stay, and a diminished morbidity rate.
Similar content being viewed by others
References
PK Amid AG Shulman IL Lichtenstein (1996) ArticleTitleOpen “tension-free” repair of inguinal hernias: the Lichtenstein technique. Eur J Surg 162 447–453 Occurrence Handle1:STN:280:BymH3Mvhs1U%3D Occurrence Handle8817221
A Arroyo P Garcia F Perez J Andreu F Candela R Calpena (2001) ArticleTitleRandomized clinical trial comparing suture and mesh repair of umbilical hernia in adults. Br J Surg 88 1321–1323 Occurrence Handle1:STN:280:DC%2BD3Mrjt1Snsw%3D%3D Occurrence Handle11578284
OM Askar (1978) ArticleTitleA new concept of the aetiology and surgical repair of paraumbilical and epigastric hernias. Ann R Coll Surg England 60 42–48 Occurrence Handle1:STN:280:CSeC383ktlw%3D
JG Balique JH Alexandre JP Arnaud S Benchetrit JL Bouillot PL Fagniez JB Flament C Gouillat P Jarsaillon M Lepere E Magne G Mantion (2000) ArticleTitleIntraperitoneal treatment of incisional and umbilical hernias: intermediate results of a multicenter prospective clinical trial using an innovative composite mesh. Hernia 4 IssueIDsuppl S10–S16
DM Bowley AN Kingsnorth (2000) ArticleTitleUmbilical hernia, Mayo or mesh? Hernia 4 195–196
MA Carbajo del Martin JC Olmo JI Blanco C de la Cuesta M Toledano F Martin C Vaquero L Inglada (1999) ArticleTitleLaparoscopic treatment versus open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc 13 250–252 Occurrence Handle1:STN:280:DyaK1M7msF2jtg%3D%3D Occurrence Handle10064757
A Celdran P Bazire MA Garcia-Urena JL Marijuan (1995) ArticleTitleHernioplasty : a tension-free repair for umbilical hernia. Br J Surg 82 371–372 Occurrence Handle7796013
MJ Costanza BT Heniford MJ Arca JT Mayes M Gagner (1998) ArticleTitleLaparoscopic repair of recurrent ventral hernias. Am Surg 64 1121–1127 Occurrence Handle1:STN:280:DyaK1M%2FlslClsQ%3D%3D Occurrence Handle9843329
EJ DeMaria JM Moss HJ Sugerman (2000) ArticleTitleLaparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia. Prospective comparison to prefascial polypropylene mesh repair. Surg Endosc 14 326–329 Occurrence Handle1:STN:280:DC%2BD3c3ltlynsQ%3D%3D Occurrence Handle10790548
M Deysine (1998) ArticleTitleVentral herniorrhaphy: treatment evolution in a hernia service. Hernia 2 15–18
BT Heniford A Park BJ Ramshaw G Voeller (2000) ArticleTitleLaparoscopic ventral and incisional hernia repair in 407 patients. J Am Coll Surg 190 645–650 Occurrence Handle1:STN:280:DC%2BD3czivFequw%3D%3D Occurrence Handle10872998
MD Holzman CM Purut K Reintgen S Eubanks TN Pappas (1997) ArticleTitleLaparoscopic ventral and incisional hernioplasty. Surg Endosc 11 32–35 Occurrence Handle1:STN:280:ByiC2cfjsFc%3D Occurrence Handle8994985
KA LeBlanc WV Booth JM Whitaker DE Bellanger (2000) ArticleTitleLaparoscopic incisional and ventral herniorrhaphy in 100 patients. Am J Surg 180 193–197 Occurrence Handle11084128
WJ Mayo (1901) ArticleTitleAn operation for the radical cure of umbilical hernia. Ann Surg 34 276–280
M Miserez F Penninckx (2002) ArticleTitleEndoscopic totally preperitoneal ventral hernia repair. Surg Endosc 16 1207–1213 Occurrence Handle1:STN:280:DC%2BD38vjt1egsw%3D%3D Occurrence Handle12189482
NT Nguyen SL Lee KL Mayer GL Furdui HS Ho (2000) ArticleTitleLaparoscopic umbilical herniorrhaphy. J Laparoendosc Adv Surg Tech A 10 151–153 Occurrence Handle1:STN:280:DC%2BD3M%2FitVagsA%3D%3D Occurrence Handle10883992
BJ Ramshaw P Esartia J Schwab EM Mason RA Wilson TD Duncan J Miller GW Lucas J Promes (1999) ArticleTitleComparison of laparoscopic and open ventral herniorrhaphy. Am Surg 65 827–832 Occurrence Handle1:STN:280:DyaK1MvhtFyrtw%3D%3D Occurrence Handle10484084
FK Toy RW Bailey S Carey CW Chappuis M Gagner LG Josephs EC Mangiante AE Park A Pomp RT Smoot Jr JF Uddo Jr GR Voeller (1998) ArticleTitleProspective, multicenter study of laparoscopic ventral hernioplasty. Preliminary results. Surg Endosc 12 955–959 Occurrence Handle1:STN:280:DyaK1c3pvVeiug%3D%3D Occurrence Handle9632869
Acknowledgements
This project was partly funded by a grant from the University of Hong Kong Committee on Research and Conference Grants. The authors acknowledge Dr. T. C. Tan for reviewing the manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lau, H., Patil, N. Umbilical hernia in adults . Surg Endosc 17, 2016–2020 (2003). https://doi.org/10.1007/s00464-003-9027-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-003-9027-7