paraumbilical hernia
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2021 ◽  
Vol 29 (01) ◽  
pp. 13-18
Author(s):  
Ahsan Nasim ◽  
Pir Muneeb Rehman ◽  
Kamran Ali ◽  
Naila Jabbar

Objective: To compare the outcomes of prolene macroporous mesh with Parietex Composite® mesh in patients undergoing Laparoscopic hernioplasty for management of Paraumbilical hernia. Study Design: Prospective Comparative study. Setting: Jinnah Hospital Lahore. Period: 1st January 2016 to 1st January 2018. Material & Methods: A total of 100 patients with diagnosis of Paraumbilical hernia, aged >18 years were included. There were two groups. In group A (n=50) prolene macroporous mesh (Covidien) was placed. In group B (n=50) Parietex Composite® mesh (Covidien) was placed. After hernioplasty all patients were followed for a period of 2 years for evaluation of primary procedure and any complications like seroma, hematoma and intestinal obstruction. Results: The mean length of stay was 2.74±2.13 days in group A, versus 2.23±1.25 in group B (p-value 0.15). Seroma formation was seen in 4 (8.0%) patients in group A versus in 02 (4.0%) patients in group B (p-value 0.40). Hematoma formation was seen in 01 (2.0%) patients in group A versus 0.0% patients in group B (p-value 0.10). There was no recurrence and intestinal obstruction in any group in two years follow up. Conclusion: There was no difference in surgical outcome and the complication between two groups of patients undergoing laparoscopic Paraumbilical hernia repair with prolene macroporous and Parietex Composite mesh. Moreover, parietex composite mesh are difficult to insert and much expensive. Therefore, prolene mesh can be safely used in patients undergoing Laparoscopic Paraumbilical hernioplasty.


2021 ◽  
Vol 15 (12) ◽  
pp. 3289-3291
Author(s):  
Aqeel Ahmad ◽  
Syed Tahir Muhammad Shah ◽  
Muhammad Rizwan Qadir ◽  
Muhammad Usman Aslam ◽  
Imran Yousaf ◽  
...  

Objective: To evaluate long term results of paraumbilical hernioplasty by onlay technique. Material & Methods: This prospective study was started in Jan 2017 and completed in Oct 2021. A total number of 196 patients having paraumbilical hernia were included in the study by convenient sampling. Patients with recurrent, strangulated and obstructed hernia as well as patients with ulcerated skin over the hernia were excluded from the study. All the patients were operated under general anesthesia with muscle relaxants. A non-absorbable standard prolene mesh (15x15 cm or 30x30 cm) was used and fixed with prolene 3-0 suture. Redivac drain was used over the mesh for minimum of three days. After discharge, all the operated cases were advised to visit the outpatient department after one week, one month, three months, six months, one year and two years. Maximum follow-up was two years and minimum was one year to assess the long term complication including recurrence. Demographic data along with diagnosis, complication, were collected and analyzed with Excel 2019. Results: Total 196 patients were operated for paraumbilical hernia. From which 53 were male and 143 were female. Minimum age was 18 years old and oldest patient was 78 years old. Average age was 40.19± 10 years, median age was 38 years. Seroma was seen in 04 patients. Superficial wound infection was observed in 02 patient no deep-seated infection was reported in our study. During three months of follow-up, numbness was noted in 03 patients and 02 patients had pain at the operation site during manual work. After two years recurrence was observed in two female patients, who failed to control their weight. Conclusion: Paraumbilical hernia is very common presentation in female patients. In order to prevent complication of hernia like, incarceration, strangulation and obstruction, early repair of the hernia is recommended in all the cases. Onlay mesh hernioplasty is one of the safest techniques which is relatively easy procedure, has a short learning curve with promising results. It has a low recurrence rate. Keywords: Onlay Mesh hernioplasty, Paraumbilical Hernia, PUH.


Author(s):  
Arti Mitra ◽  
Unmed Chandak ◽  
Shiv Kumar Sahu ◽  
Yuvraj Pawaskar ◽  
Akanksha Waldia

Background: Laparoscopic repair of umbilical and paraumbilical hernia has largely replaced conventional (Open) repair. The purpose of the study was to compare the effectiveness of laparoscopic vs. open repair of umbilical & para umbilical hernia in a tertiary care government hospital. Methods: A total 50 patients of age >18 years diagnosed with umbilical and paraumbilical hernia who underwent laparoscopic and open hernia repair from May2018 to Nov 2020 were enrolled and divided into two groups of 25 patients in each. The patients were followed up in the post-operative period in the wards during daily rounds till the time of discharge; 1 and 6 months after discharge and yearly. Results: The mean age for open group was 44.24±7.68years while the mean age for laparoscopic group was 50.0±11.82years. Operative time was more in laparoscopic repair (81.68±18.37min) as compared to open (55.44±16.54min). Post-operative pain (VAS score) was greatest in the open group in comparison to lap group at 6 hr, 24 hr, day 8 and at 1month. Postoperative overall complication rate (Infection, seroma and recurrence) was 12% in the laparoscopic group and 28% in the open group. Recovery was faster with laparoscopic repair with a mean postoperative hospital stay of 3.28days as compared to 5.88days for open mesh repair. Patients treated with laparoscopic repair were early return to routine activity and work. Conclusion: The laparoscopic approach appears to be safe, effective and acceptable. It is a complex but very efficient method in experienced hands and it offered a significant advantage over open repair.


2021 ◽  
pp. 26-27
Author(s):  
P. Surendhar ◽  
R. Rani Suganya ◽  
P. Anitha

One of the most underrated aspects of surgical procedure is the very placement of skin incisions. Several factors inuence the post-operative morbidity, outcome and satisfaction of a patient. One such being the very placement of a skin incision by the surgeon. Even though the trend nowadays is to opt for laparoscopic and mini-incision surgery, the rst and basic rule in surgery is to have an incision that will be comfortable for the surgeon and provide adequate access to the area of pathology. The purpose of this study is to compare vertical and horizontal skin incisions during umbilical and paraumbilical hernia repair that makes the surgical technique and post-operative outcome much more favorable. In this study, we compare the intraoperative difculty, post operative wound healing and morbidity between these two techniques.


2021 ◽  
Vol 74 (2) ◽  
pp. 220-224
Author(s):  
Valeriy V. Boiko ◽  
Kyrylo Yu. Parkhomenko ◽  
Kostyantyn L. Gaft ◽  
Oleksandr E. Feskov

The aim of the study was to determine the possibility and effectiveness of simultaneous surgical interventions in umbilical and paraumbilical hernia repair. Material and methods: 148 case histories were analyzed concerning patients who were routinely admitted to the surgical department of the Kharkiv Regional Council’s Municipal Non-Profit Enterprise «Regional Clinical Hospital» between 2017 and 2019, and who underwent umbilical and paraumbilical hernia repair simultaneously with operations related to some other surgical pathology (group 1, n = 67) or in separate interventions (group 2, n = 81). All patients were routinely operated after a set of mandatory and additional general clinical, laboratory and instrumental research conducted in accordance with the existing guidelines. The structure and results of surgical interventions related to the underlying disease and simultaneous operations were studied. Results: Simultaneous operations were performed for comorbid cholecystolithiasis, diaphragmatic esophageal hernia with gastroesophageal reflux, inguinal hernia, white line hernia, benign diseases of the uterus and uterine appendages et al. The frequency of complications and recurrences of hernia in patients with simultaneous and isolated of umbilical hernia repair did not differ significantly. The outcome of the operation mostly depended on the method of operation (postoperative complications were most often observed in open sutures repair and were absent in laparoscopic hernia repair). Additional risk factors were weight gain and diabetes. Conclusions: Summarizing the data obtained, it can be concluded that application of modern endovideoscopic techniques in surgery makes simultaneous surgical interventions not only possible but also necessary in the presence of concomitant abdominal pathology that requires surgical treatment.


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