Single-incision laparoscopic preperitoneal repair: novel approach to umbilical hernia surgery (with video)

Umbilical hernia is a frequently encountered surgical condition. Its optimal repair method remains debatable. This retrospective study presents a novel technique for umbilical hernia repair, the single-incision laparoscopic (SIL) preperitoneal repair, and compares it with the currently most widely adopted technique, intraperitoneal onlay mesh (IPOM).

We reviewed cases of umbilical hernias (> 1 cm) treated with either SIL or IPOM at our center, detailing the SIL procedure and comparing demographics, complications, costs, and outcomes.

In the study of 107 umbilical hernia patients, 61 underwent SIL repair and 46 underwent IPOM repair. Both groups had similar baseline characteristics. SIL had a shorter median operating time (57 vs. 64 min, p = 0.030) and a shorter postoperative stay (2 vs. 2.7 days, p = 0.019). SIL also had lower hospitalization costs (1709.7 ± 177.3 vs. (2545.4 ± 528.0 EUR, p < 0.001). No recurrences or mesh infections were observed during follow-up.

Compared to the current laparoscopic IPOM plus standard, SIL preperitoneal repair demonstrates comparable safety and represents a feasible and reproducible minimally invasive alternative within the extraperitoneal spectrum. While this study observed shorter operative time and lower institutional costs, these findings should be interpreted with caution. No recurrences were observed during the short-term follow-up. This technique can be standardized, but further comparative studies are required to define its role relative to other established repairs.