Management of concomitant umbilical hernia with laparoscopic cholecystectomy
DOI:
https://doi.org/10.18203/2349-2902.isj20231959Keywords:
Laparoscopic cholecystectomy, Umbilical hernia, Mesh hernioplasty, Suture, Recurrence, ObesityAbstract
Background: During laparoscopic cholecystectomy (LC) procedures, umbilical abnormalities may present technical challenges for general surgeons and increase the risk of incisional hernia. Objective was to identify the best repair technique to go along with LC for known or incidentally discovered umbilical hernias.
Methods: In this study, retrospective review of the medical records of patients who had concurrent LC and umbilical hernia repair was done. Between January 2020 and January 2023, our institution performed LC on 600 patients, 65 (10.5%) of whom also underwent simultaneous UHR and LC. The analysis included 65 (10.5%) patients who met the inclusion requirements. Patients with umbilical hernias were identified during the preoperative phase by a clinical examination.
Results: Mean age of 65 qualifying patients who underwent LC+UHR was 54.7±14.9 years (range 23-81 years) Men and women comprised 41 (65.6%) and 24 (34.4%) of these 65 patients, respectively. Median VAS pain scores measured on the first, second and seventh days were higher in group 3 compared with those of the other two groups. There were statistically significant differences between different days in groups 1, 2 and 3 (p=0.01).
Conclusions: The outcomes of the UHR with mesh after laparoscopic surgeries appear to be better for either obese or non-obese patients than primary suture techniques in recurrence rates.
References
Sari YS, Tunali V, Tomaoglu K, Karagoz B, Guneyi A, Karagoz I. Can bile duct injuries be prevented? "A new technique in laparoscopic cholecystectomy". BMC Surg. 2019;5:14.
Berggren U, Gordh T, Grama D, Haglund U, Rastad J, Arvidsson D. Laparoscopic versus open cholecystectomy: Hospitalization, sick leave, analgesia and trauma responses. Br J Surg. 2018;81:1362-5.
Perrakis E, Velimezis G, Vezakis A, Antoniades J, Savanis G, Patrikakos V. A new tension-free technique for the repair of umbilical hernia, using the Prolene Hernia System--early results from 48 cases. Hernia. 2013;7:178-80.
Lau H, Patil NG. Umbilical hernia in adults. Surg Endosc. 2013;17:2016-20.
Gett RM, Joseph MG. A safe technique for the insertion of the Hasson canula. ANZ J Surg. 2014;74:797-8.
Kelly AM. The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emerg Med J. 2011;18:205-7.
Azurin DJ, Go LS, Arroyo LR, Kirkland ML. Trocar site herniation following laparoscopic cholecystec-tomy and the significance of an incidental preexisting umbilical hernia. Am Surg. 2015;61:718-20.
Vagenas K, Karamanakos SN, Spyropoulos C, Panagiotopoulos S, Karanikolas M, Stavropoulos M. Laparoscopic cholecystectomy: A report from a single center. World J Gastroenterol. 2006;12:3887-90.
Sauerland S, Korenkov M, Kleinen T, Arndt M, Paul A. Obesity is a risk factor for recurrence after incisional hernia repair. Hernia. 2014;8:42-6.
Arroyo Sebastian A, Perez F, Serrano P, Costa D, Oliver I, Ferrer R, et al. Is prosthetic umbilical hernia repair bound to replace primary herniorrhaphy in the adult patient? Hernia. 2012;6:175-7.
Plaus WJ. Laparoscopic trocar site hernias. J Laparoendosc Surg. 2013;3:567-70.
Bencini L, Sanchez LJ, Scatizzi M, Farsi M, Boffi B, Moretti R. Laparoscopic treatment of ventral hernias: prospective evaluation. Surg Laparosc Endosc Percutan Tech. 2013;13:16-9.
De Giuli M, Festa V, Denoye GC, Morino M. Large postoperative umbilical hernia following laparoscopic cholecystectomy. A case report. Surg Endosc. 2014;8:904-5.
Celdran A, Bazire P, Garcia-Urena MA, Marijuan JL. H-hernioplasty: A tension-free repair for umbilical hernia. Br J Surg. 2015;82:371-2.
Aura T, Habib E, Mekkaoui M, Brassier D, Elhadad A. Laparoscopic tension-free repair of anterior abdominal wall incisional and ventral hernias with an intraperitoneal Gore-Tex mesh: Prospective study and review of the literature. J Laparoendosc Adv Surg Tech A. 2012;12:263-7.