Prosthetic repair of umbilical hernias in adults with local anesthesia in a day-case setting: a comprehensive report from a specialized hernia center

Abstract

The repair of umbilical hernias with local anesthesia in a day-case setting is a good option, with low infection and recurrence rates. Most patients can be discharged early as planned. Separate doses and total volume of local anesthetic agents needed for umbilical hernia repair are clearly higher than those used in inguinal hernia repair. Patients with higher BMI, recurrent hernia, and defects larger than 3 cm may require higher local analgesic doses. The patient satisfaction is very good when the patients are provided with detailed information about day-surgery and local anesthesia.

Current options in umbilical hernia repair in adult patients

“…Open onlay mesh placement is the easiest technique; however, it requires subcutaneous dissection that may cause seroma or hematoma and eventually result in surgical site infection in some cases. Mesh can also be placed in a preperitoneal or sublay position (5,11). This may require more surgical experience and skill but avoids extensive subcutaneous dissection and reduces seroma formation and possibly result in less recurrence.…”

“…In general, umbilical hernias are more common in women than men; however, there are series in which male patients are more frequent (5). Typically, a lump is observed around the umbilicus.…”

A Collective Review on Mesh-Based Repair of Umbilical and Epigastric Hernias

“…Seven of the included studies were prospective studies [6][7][8][18][19][20][21]. Four of them were graded level II evidence [6,7,19,20], one level III-1 [18], and two studies were graded level III-2 evidence [8,21].…”

“…Four of them were graded level II evidence [6,7,19,20], one level III-1 [18], and two studies were graded level III-2 evidence [8,21]. Some of the remaining retrospective studies were also graded level III-2 evidence [9,10,[22][23][24][25][26][27][28][29] or level IV [30][31][32].…”

“…Postoperative pain was noted separately and not included in the complication rate. Postoperative pain was described in seven studies, of which only four studies were suitable for analysis [7,[18][19][20][21][22]27]. The other three studies reported only mean pain scores after surgery; the number of patients suffering from postoperative pain was not reported [19].…”