Mesh plug repair for paraumbilical hernia

S N Sinha, T Keith
Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 2004, 2 (2): 99-102

BACKGROUND: The standard method of repair of paraumbilical hernia (PUH) is by the Mayo technique, using a double-breasted flap of the rectus sheath. The reproducibility of this technique in the hands of others is highly variable. The present study describes and evaluates the application of a Prolene mesh plug in the repair of PUH. The use of a mesh plug in hernia repair is not a new concept with previous investigators yielding consistently excellent results in the repair of femoral and inguinal hernias.

METHODS: The study is a retrospective analysis of hospital records and telephone interviews of 34 patients having undergone PUH repair using the mesh plug technique in the period March 1998- May 2002. There were 20 males and 14 females with a median age of 53 years (range 34-86 years). Seventy-six percent (26) of the patient sample was obese (median BMI 33). Whenever possible local anaesthetic was used. Principal outcome measures studied were post-operative complications, recurrences, length of stay in hospital, post-operative analgesia, duration of drain, return to normal activities and patient satisfaction.

RESULTS: Post-operative complications encountered included one case of seroma and a single wound infection with recurrence. Ninety-seven percent (32) of patients were satisfied with the procedure.

CONCLUSION: Mesh plug repair can be performed with minimal postoperative complications, low recurrence rate, minimal post-operative pain and achieving excellent patient satisfaction. Prosthetic mesh plug repair under local anaesthetic could become the standard treatment for PUH in adults.

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