Primary Umbilical Hernia Repair: A Large-Volume Single-Surgeon Study

Area of Science:

• Surgical techniques
• Hernia repair
• Gastrointestinal surgery

Background:

• Conflicting views exist on optimal repair techniques for small umbilical hernias (UH).
• Mesh repair is often considered for UH, but primary repair outcomes require further investigation.

Purpose of the Study:

• To compare recurrence rates of primary umbilical hernia repair with reported mesh repair outcomes.
• To evaluate the safety and durability of primary UH repair in a large-volume, single-surgeon practice.

Main Methods:

• Retrospective review of 244 primary umbilical hernia repairs performed between 2012 and 2017.
• Analysis of recurrence rates, hernia defect size, patient BMI, and suture material.
• Median follow-up of 3.4 years.

Main Results:

• Seven recurrences (3%) were observed in 244 primary repairs.
• Hernia defects in recurrent cases were significantly larger (2 cm) than in non-recurrent cases (1.4 cm; P < 0.05).
• Low infection and recurrence rates were achieved with primary repair.

Conclusions:

• Primary umbilical hernia repair demonstrates low recurrence and infection rates, comparable to mesh repair.
• Effective patient selection (lower BMI, smaller defects) and use of absorbable monofilament sutures contribute to successful primary UH repair.
• This study supports primary repair as a safe and durable option for small umbilical hernias.