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Mesh plug repair for paraumbilical hernia
1Department of Surgery, University of Tasmania & Royal Hobart Hospital, Tasmania, Australia.
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.
Insights
Paraumbilical hernia (PUH) repair using a Prolene mesh plug offers a safe and effective alternative to traditional methods. This technique demonstrates minimal complications, low recurrence, and high patient satisfaction, suggesting it could become a new standard for PUH treatment.
Area of Science:
- Surgical Innovation
- Hernia Repair Techniques
- Prosthetic Materials in Surgery
Background:
- The Mayo technique for paraumbilical hernia (PUH) repair, using a double-breasted rectus sheath flap, exhibits variable reproducibility.
- The efficacy of mesh plugs in repairing femoral and inguinal hernias is well-established.
Purpose of the Study:
- To describe and evaluate the application of a Prolene mesh plug for paraumbilical hernia (PUH) repair.
- To assess the outcomes of mesh plug repair in terms of complications, recurrence, and patient satisfaction.
Main Methods:
- Retrospective analysis of 34 patients (20 males, 14 females) undergoing PUH repair with a mesh plug (March 1998-May 2002).
- Median age of 53 years; 76% were obese (median BMI 33).
- Local anesthesia was used when feasible; outcomes included complications, recurrence, hospital stay, pain, drain duration, return to activity, and satisfaction.
Main Results:
- One case of seroma and one wound infection with recurrence were observed.
- Ninety-seven percent (32/34) of patients reported satisfaction with the procedure.
Conclusions:
- Mesh plug repair for PUH is associated with minimal postoperative complications and a low recurrence rate.
- Excellent patient satisfaction and minimal postoperative pain were achieved.
- Prosthetic mesh plug repair, particularly under local anesthesia, shows potential as a standard treatment for adult PUH.
