‘’A Comparative Study of the Efficacy and Advantages of Laparoscopic Repair of Umbilical and Paraumbilical Hernia Over Conventional Open Repair Among Patients Attending Meenakshi Medical College Hospital and Research Institute, Kanchipuram’’

Abstract

Introduction: Umbilical and paraumbilical hernias account for approximately 5% of all primary hernias. Approximately 90% of adult umbilical hernias are acquired rather than due to the persistence of infantile umbilical hernias. Often in adults, the hernia does not occur through the umbilical scar but is a protrusion through the linea alba, just above or sometimes just below the umbilicus, the so-called paraumbilical hernias. Predisposing factors for umbilical and paraumbilical hernias include any condition resulting in increased intra-abdominal pressure, such as obesity, multiparous women, ascites, and intra-abdominal malignancy, and as such, the incidence is reported to be up to five times higher in females compared to males. Biomechanically, the umbilical zone is naturally weaker because it allows more transverse stretch, hence the reason for the hernias.

Aim:To compare the outcomes of laparoscopic repair of umbilical and paraumbilical hernias (both primary closure and mesh repair) over the conventional open techniques used routinely.

Objectives: 1. To derive conclusions about the advantages of laparoscopic closure of the defect in umbilical and paraumbilical hernias over conventional open repair involving both primary suturing and the on-lay mesh technique with respect to the shorter return to normal activity, lesser risk of infection, fewer complications, a lower incidence of recurrences, and a longer-term outcome.                                                                                 . 2.To derive conclusions about the selection of surgical techniques for repair in selected scenarios.

Methods: A comparative study for the efficacy and advantages of laparoscopic repair of umbilical and paraumbilical hernias over conventional open repairs was conducted at Meenakshi Medical College Hospital & Research Institute in Kanchipuram, among 30 study participants, between September 2022 and August 2023.

Results&Conclusions

• Laparoscopic repair of umbilical and paraumbilical hernias is a safe and effective technique when compared with the conventional open methods of repair, even in the presence of multiple previous abdominal surgeries and large defects. It also allows for identification of previously undiagnosed secondary hernia defects. Laparoscopic method of repair clearly supersedes the conventional open method in terms of Early return to normal activities, lesser incidence of pain, sensory disturbances, wound infections and complications along with significantly reduced incidences of recurrences in the long run.