Primary non-complicated midline ventral hernia: overview of approaches and controversies
- 32 Downloads
Umbilical hernias and epigastric hernias are some of the most common hernias in the world. Umbilical and epigastric hernia defects can range from small (<1 cm) to very large/complex hernias, and treatment options should be tailored to the clinical situation. Repair techniques include open, laparoscopic, and robotics options, each with advantages and disadvantages. A mesh-based repair is indicated in most cases due to having fewer associated recurrences. Overall outcomes are favorable following umbilical and epigastric hernia repairs; however, some patients have chronic complaints mostly related to recurrences. This report is an overview of available techniques for repair of umbilical and epigastric hernias. It also discusses ongoing controversies related to umbilical and epigastric hernia repairs, the limitations of available literature, and the need for future research.
KeywordsUmbilical Hernia Repair Mesh Primary
No funding was received for this work.
Compliance with ethical standards
Conflict of interest
WWH has the following activities (not directly related to the current work) to disclosure: CR Bard: honorarium, speaking, and research support; WL Gore: research support and speaking; Lifecell: consulting; intuitive: speaking, and consulting. JAB, PLT, and FEE declare that they have no conflict of interest.
Approval from the institutional review board was not required for this study.
Human and animal rights
This article does not contain any studies with human participants or animals performed by any of the authors.
For this retrospective review, formal consent is not required.
- 5.Heniford BT, Park A, Ramshaw BJ, Voeller G (2003) Laparoscopic repair of ventral hernias: nine years' experience with 850 consecutive hernias. Ann Surg 238:391–399. https://doi.org/10.1097/01.sla.0000086662.49499.ab (discussion 399–400) Google Scholar
- 6.Lanfranco AR, Castellanos AE, Desai JP, Meyers WC (2004) Robotic surgery: a current perspective. Ann Surg 239:14–21. https://doi.org/10.1097/01.sla.0000103020.19595.7d CrossRefGoogle Scholar
- 10.Christoffersen MW, Helgstrand F, Rosenberg J, Kehlet H, Bisgaard T (2013) Lower reoperation rate for recurrence after mesh versus sutured elective repair in small umbilical and epigastric hernias. A nationwide register study. World J Surg 37:2548–2552. https://doi.org/10.1007/s00268-013-2160-0 CrossRefGoogle Scholar
- 11.Kaufmann R, Halm JA, Eker HH, Klitsie PJ, Nieuwenhuizen J, van Geldere D, Simons MP, van der Harst E, van’t Riet M, van der Holt B, Kleinrensink GJ, Jeekel J, Lange JF (2018) Mesh versus suture repair of umbilical hernia in adults: a randomised, double-blind, controlled, multicentre trial. Lancet 391:860–869. https://doi.org/10.1016/S0140-6736(18)30298-8 CrossRefGoogle Scholar
- 12.Bisgaard T, Kaufmann R, Christoffersen MW, Strandfelt P, Gluud LL (2018) Lower risk of recurrence after mesh repair versus non-mesh sutured repair in open umbilical hernia repair: a systematic review and meta-analysis of randomized controlled trials. Scand J Surg. https://doi.org/10.1177/1457496918812208 Google Scholar
- 13.Cassie S, Okrainec A, Saleh F, Quereshy FS, Jackson TD (2014) Laparoscopic versus open elective repair of primary umbilical hernias: short-term outcomes from the American College of Surgeons National Surgery Quality Improvement Program. Surg Endosc 28:741–746. https://doi.org/10.1007/s00464-013-3252-5 CrossRefGoogle Scholar
- 14.Ramshaw BJ, Esartia P, Schwab J, Mason EM, Wilson RA, Duncan TD, Miller J, Lucas GW, Promes J (1999) Comparison of laparoscopic and open ventral herniorrhaphy. Am Surg 65:827–831 discussion 831–822 Google Scholar
- 15.Gonzalez R, Mason E, Duncan T, Wilson R, Ramshaw BJ (2003) Laparoscopic versus open umbilical hernia repair. JSLS 7:323–328Google Scholar