A scarless technique of umbilical hernia repair in the adult population

Mislowsky, Angela; Hemphill, Amani F.; Nasrallah, D. V.

doi:10.1007/s10029-008-0396-7

Cited by 16 publications

(3 citation statements)

References 6 publications

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“…Kurpiewski et al ( 12 ) described a technique of using 3–3.5 cm incisions for placement of mesh in the preperitoneal space. Mislowsky et al ( 13 ) described a scar-less suture repair technique (without mesh) for UHs <2 cm in size by utilizing a vertical intra-umbilical incision. Arslan et al ( 14 ) reported their technique of UH repair utilizing small intra-umbilical curved incisions for hernias <4 cm in size.…”

Section: Discussionmentioning

confidence: 99%

Minimal Incision Scar-Less Open Umbilical Hernia Repair in Adults â€“ Technical Aspects and Short-Term Results

et al. 2014

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Background: There is no gold standard technique for umbilical hernia (UH) repair. Conventional open UH repair often produces an undesirable scar. Laparoscopic UH repair requires multiple incisions beyond the umbilicus, specialized equipments, and expensive tissue separating mesh. We describe our technique of open UH repair utilizing a small incision. The technique was derived from our experience with single incision laparoscopy. We report the technical details and short-term results.Methods: This is a retrospective analysis of the first 20 patients, who underwent minimal incision scar-less open UH repair, from June 2011 to February 2014. A single intra-umbilical curved incision was used to gain access to the hernia sac. Primary suture repair was performed for defects up to 2 cm. Larger defects were repaired using an onlay mesh. In patients with a BMI of 30 kg/m2 or greater, onlay mesh hernioplasty was performed irrespective of the defect size.Results: A total of 20 patients, 12 males and 8 females underwent the procedure. Mean age was 50 (range 29–82) years. Mean BMI was 26.27 (range 20.0–33.1) kg/m2. Average size of the incision was 1.96 range (1.5–2.5) cm. Mesh hernioplasty was done in nine patients. Eleven patients underwent primary suture repair alone. There were no postoperative complications associated with this technique. Average postoperative length of hospital stay was 3.9 (range 2–10) days. Mean follow-up was 29.94 months (2 weeks to 2.78 years). On follow-up there was no externally visible scar in any of the patients. There were no recurrences on final follow-up.Conclusion: This technique provides a similar cosmetic effect as obtained from single port laparoscopy. It is easy to perform, safe, offers good cosmesis, does not require incisions beyond the umbilicus, and cost effective, with encouraging results on short-term follow-up. Further research is needed to assess the true potential of the technique and the long-term results.

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Section: Discussionmentioning

confidence: 99%

Minimal Incision Scar-Less Open Umbilical Hernia Repair in Adults â€“ Technical Aspects and Short-Term Results

et al. 2014

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“…Although some reports have reported transumbilical incision repair, 2,3 these methods do not allow size adjustment when the umbilicus is large. Normal umbilical diameter is said to be 15 mm.…”

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confidence: 99%

Transumbilical Repair for Umbilical Hernia: A New Technique

Ohba

Yamamoto

Matsushima

et al. 2022

The American Surgeon™

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Although there are many reports on surgical repair for umbilical hernia, there is no standard procedure at present. Since 2012, we have performed surgery with transumbilical repair using an original procedure. With this procedure, a longitudinal incision is made in the umbilicus, and the fascial defect is closed. Excess skin is excised at a fixed length. The fascia and dermis are sutured vertically over a length of 15 mm. A total of 424 patients with pediatric umbilical hernia who underwent this procedure between September 2012 and December 2020 were reviewed. The mean operative duration was 52 minutes. All patients were followed up to 6 months after surgery. Postoperative complications included infection in 15 patients and wound granulation in 5 patients. The morphology of the umbilicus is natural and satisfying. We conclude that this procedure is safe and simple and the results are satisfactory.

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“…Factors and diseases that lead to elevated intraabdominal pressure such as prostatic hypertrophy, chronic obstructed pulmonary disease, constipation, ascites, morbid obesity, and pregnancy also increase risk of hernia formation. [1][2][3] Umbilical hernia repair (UHR) was revolutionized by Dr. William J. Mayo in 1901 when he described his "vest-over-pants" technique to imbricate the fascial edges of the hernia defect. 4 This technique led to a dramatic reduction in recurrence rates in the early 20th century, though these rates are considered high by current standards.…”

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confidence: 99%

Identifying Effectors of Outcomes in Patients with Large Umbilical Hernias

Groene

Heniford

Prasad

et al. 2016

The American Surgeon

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Quality of life (QOL) has become an important focus of hernia repair outcomes. This study aims to identify factors which lead to ideal outcomes (asymptomatic and without recurrence) in large umbilical hernias (defect size ≥9 cm2). Review of the prospective International Hernia Mesh Registry was performed. The Carolinas Comfort Scale was used to measure QOL at 1-, 6-, and 12-month follow-up. Demographics, operative details, complications, and QOL data were evaluated using standard statistical methods. Forty-four large umbilical hernia repairs were analyzed. Demographics included: average age 53.6 ± 12.0 and body mass index 34.9 ± 7.2 kg/m2. The mean defect size was 21.7 ± 16.9 cm2, and 72.7 per cent were performed laparoscopically. Complications included hematoma (2.3%), seroma (12.6%), and recurrence (9.1%). Follow-up and ideal outcomes were one month = 28.2 per cent, six months = 42.9 per cent, one year = 55.6 per cent. All patients who remained symptomatic at one and two years were significantly symptomatic before surgery. Symptomatic preoperative activity limitation was a significant predictor of nonideal outcomes at one year ( P = 0.02). Symptomatic preoperative pain was associated with nonideal outcomes at one year, though the difference was not statistically significant ( P = 0.06). Operative technique, mesh choice, and fixation technique did not impact recurrence or QOL. Repair of umbilical hernia with defects ≥9 cm2 had a surprising low rate of ideal outcomes (asymptomatic and no recurrence). All patients with nonideal long-term outcomes had preoperative pain and activity limitations. These data may suggest that umbilical hernia should be repaired when they are small and asymptomatic.

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A scarless technique of umbilical hernia repair in the adult population

Abstract: The technique described here is based on one used in the pediatric population. Our repair is applied to adults with hernias of less than 2 cm in diameter. At the final follow up no scar can be seen as it has been buried within the umbilicus.

Cited by 16 publications

References 6 publications

Minimal Incision Scar-Less Open Umbilical Hernia Repair in Adults â€“ Technical Aspects and Short-Term Results

Minimal Incision Scar-Less Open Umbilical Hernia Repair in Adults â€“ Technical Aspects and Short-Term Results

Transumbilical Repair for Umbilical Hernia: A New Technique

Identifying Effectors of Outcomes in Patients with Large Umbilical Hernias

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