A study on surgical management of paraumbilical hernia

Paraumbilical hernia is a common condition encountered by surgeons. Though PUH has a tendency to be associated with high morbidity and mortality in comparison with inguinal hernia because of the higher risk of incarceration and strangulation, there still appears to be a certain discrepancy between its importance and the attention it has received in the literature. Hence PUH needs to be studied further. Objectives of the study: • To study the different surgical Management of paraumbilical hernia. • Immediate Postoperative complications. Methods: This is a prospective study conducted in ESI Model Hospital attached to ESIC MC & PGIMSR from January 2015 to June 2016. Ninenty cases have been studied. Patients with umbilical port site hernia, with previous mesh implantation, pregnant women and those requiring emergency surgery have been excluded. Twenty four patients underwent Anatomical repair and 66 patients underwent Mesh repair. Follow up was done in 1week, 4 weeks, 6 months, 12 months and 18 months. Results: Paraumbilical hernia was more common in middle-aged patients and in females. Commonest predisposing factors were multiparity and obesity. Postoperative complications like seroma, haematoma, infection were similar in both procedures (Anatomical repair and Mesh repair). There were no recurrence following Anatomical repair. There was one recurrence following Mesh repair. Conclusion: In our study, paraumbilical hernia was found more commonly between fourth and fifth decade of life with female: male ratio of 1.4:1. Most common presenting symptom was a soft bulge located adjacent to the umbilicus which is readily reducible. Multiparity was the most common precipitating factor in females and smoking was most common precipitating factor in males. Percentage of recurrence following Anatomical repair was 0% and following mesh repair was 0.015%.