Improving postoperative outcomes in laparoscopic umbilical hernia repair

Bulgarian Medical Journal, 2024, 18(2), 32-37.

A. Arabadzhiev, Tsv. Popov

Clinic of Surgery, UMHAT “Alexandrovska”, Department of Surgery, Medical University – Sofia

Abstract. Introduction: Umbilical hernia is prevalent across the population, with a higher incidence observed in females. Over recent years, various hernia repair techniques have emerged and been adopted. They prioritize minimal surgical trauma, shorter hospital stay length, rapid recovery, and aim to minimize post-operative pain and complications, and ensure satisfactory cosmetic outcomes. In the present study, we analyzed postoperative factors following laparoscopic intraperitoneal onlay mesh repair (IPOM) plus). Аim: To compare different IPOM plus techniques in terms of postoperative factors, such as pain, seroma formation, early recurrence, and aesthetic result. Material and methods: The study examined a total of 64 patients with a diagnosed umbilical hernia for the period 2020-2023. There were 21 male patients, and a total of 43 female patients. The operated patients were divided into 3 groups – Group A – IPOM plus (n = 38), Group B – IPOM plus + defect closure (n = 14), Group C – IPOM plus + defect closure + umbilication (n = 12). Results: The highest incidence of postoperative seroma was observed in Group A (100%), followed by Group B (71.43%) and Group C (0%). There was no early recurrence and an unsatisfactory aesthetic result only in Group C. The most significant pain syndrome was reported in Group C (48.24%). Conclusion: IPOM plus with closure of the hernial defect and umbilication effectively prevents seroma formation, thus alleviating patient discomfort. This technique not only yields superior cosmetic outcomes but also reduces the likelihood of postoperative recurrence. However, a drawback of this method is the heightened pain syndrome and prolonged discomfort experienced by patients.

Key words: umbilical hernia, seroma, pain, composite mesh, complications

Address for correspondence: Angel Arabadzhiev, MD, е-mail: a.arabadzhiev@medfac.mu-sofia.bg