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[Without Net and Double Floor: Comparison of Umbilical Hernia Repair by Spitzy in Children and Adults]
Laura Kuck1, Florian Seitz1, Armin Wiegering1
1Abteilung für Kinderchirurgie, Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie, Zentrum Operative Medizin, Würzburg, Deutschland.
Insights
The Spitzy herniotomy method using direct suture is highly effective for treating umbilical hernias in children, showing a low recurrence rate of 1.1%. This traditional method remains the gold standard for pediatric cases, with mesh implantation not being necessary.
Area of Science:
- Pediatric Surgery
- General Surgery
- Abdominal Wall Reconstruction
Background:
- Umbilical hernias affect both children and adults.
- The Spitzy method has been the standard surgical treatment for pediatric umbilical hernias for over a century.
- Mesh use is increasing in adult umbilical hernia repair.
Purpose of the Study:
- To analyze the recurrence rate of Spitzy herniotomy in pediatric and adult patients.
- To compare the effectiveness of direct suture repair versus mesh implantation in umbilical hernia treatment.
Main Methods:
- A 7-year retrospective study evaluated 370 children (<16 years) and 106 adults (>16 years) who underwent umbilical hernia surgery.
- Pediatric patients were treated with the Spitzy method (direct suture).
- Adult patients included a comparison group of 31 treated with direct suture.
Main Results:
- Pediatric patients (average age 33.81 months) had a low recurrence rate of 1.1% after direct Spitzy suture.
- Adult patients (average age 54.55 years) treated with direct suture had a significantly higher recurrence rate of 12.9%.
- The study highlights a marked difference in recurrence rates between pediatric and adult direct suture repairs.
Conclusions:
- Direct suture umbilical herniotomy (Spitzy method) remains the gold standard and method of choice for pediatric umbilical hernias.
- Mesh implantation is not indicated for umbilical hernia repair in children.
- The findings support the continued use of the Spitzy method in pediatric populations due to its low recurrence rates.
Abstract:
Umbilical hernia occur in both adults and children. For over 100 years, umbilical hernia in children has been treated surgically by the Spitzy method. With adult patients, meshes are being increasingly used. The purpose of our study was to analyse Spitzy herniotomy with respect to the recurrence rate in children and adults.
Material And Methods:
Over a period of 7 years, 383 children (age < 16 years) with umbilical hernia were treated surgically; after applying the exclusion criteria, 370 patients were evaluated. At the same time, 106 adult patients (age > 16 years) were operated for an umbilical hernia: 31 patients were treated with direct suture and thus are included in our study as comparison group.
Results:
The young patients had an average age of 33.81 months and were 44% female and 56% male. After direct Spitzy suture, a low recurrence rate of 1.1% (n = 4) in infancy could be achieved. The average age of the adult patients was 54.55 years; 32% were female, 68% male. In comparison to the group of children, the recurrence rate in adult surgery was 12.9% (n = 4) after direct suture.
Conclusion:
As confirmed in our study, umbilical herniotomy by direct suture in childhood has been the method of choice and gold standard for more than 100 years. Mesh implantation is still not necessary in childhood.
