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Updated: May 6, 2026
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Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
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UMBILICAL AND EPIGASTRIC HERNIA REPAIR: A SYSTEMATIC REVIEW
José Roberto Alves1, Luis Felipe Mondardo Spengler1, Leonardo Busch Justino1
1Universidade Federal de Santa Catarina, Department of Surgery - Florianópolis (SC), Brazil.
Summary
Mesh repair is superior for abdominal wall hernias larger than 1 cm, while sutures suffice for smaller defects. Laparoscopic repair may benefit from fibrin sealant fixation. Further research is needed.
Area of Science:
- General Surgery
- Abdominal Wall Surgery
Background:
- Umbilical and epigastric hernias are common abdominal wall defects with non-standardized treatments.
- Lack of clear guidelines necessitates evidence-based recommendations for optimal patient outcomes.
Approach:
- Systematic review and qualitative analysis of 15 randomized controlled trials (RCTs) published within the last 20 years.
- Searched major databases (PubMed/Medline, Cochrane, SciELO, LILACS) for adult patients (≥18 years) with umbilical/epigastric hernias.
- Assessed risk of bias using the Cochrane Risk of Bias Tool for study quality evaluation.
Key Points:
- Mesh repair demonstrates superiority for epigastric/primary umbilical hernias with defects >1 cm, including emergency cases.
- Suture repair remains a viable option for defects <1 cm.
- Laparoscopic repair shows potential advantages with fibrin sealant fixation and recommended fascial defect closure.
Conclusions:
- Evidence supports mesh use for larger defects (>1 cm) in umbilical and epigastric hernia repair.
- Suture repair is appropriate for smaller defects (<1 cm).
- Further high-quality RCTs are required to elucidate optimal mesh types, positioning, fixation techniques, and the role of video-assisted laparoscopic surgery, particularly for umbilical hernias.
