Abstract
Background:
Paraumbilical hernias are a common surgical problem constituting about 33% of all anterior abdominal wall hernias. Since Mayo popularized the simple suture repair, there has been a continuous evolution of different techniques for repairing paraumbilical hernias due to the high recurrence rate attendant to the simple suture repair. With the advent of mesh came significant wound complications that led surgeons to introduce the laparoscopic technique. However, there is as yet no consensus on the optimal repair technique for paraumbilical hernias. This study aimed to determine the clinical presentations, various repair techniques, and their outcomes in managing paraumbilical hernias.
Materials and Methods:
This was a prospective descriptive study that was carried out from August 2018 to July 2020. 75 patients who fulfilled the inclusion criteria were recruited for the study. Data was collected using a proforma. Variables of interest were age, sex, body mass index, co-morbidities, type of operation and duration, post-op pain score, duration of hospital stay, wound complications and recurrence. Follow up was for 6 months.
Results:
57 patients were females, and 18 males. The mean age was 53 years. 12 patients had co-morbidities. 72 patients had BMI≥ 25kg-m2. 52 patients underwent open repair (simple suture or mesh) while 23 cases were repaired by laparoscopic mesh implantation (intra-peritoneal Onlay or pre-peritoneal Onlay mesh). All 18 emergency cases had an open repair. 17 patients in the open and 5 in the lap groups developed wound complications. Mean post-op pain on day 1 was 4.71+/-0.96 and 5.37+/-0.96 in the lap and open groups, respectively (p-value= 0.003). The mean duration of hospital stay was 5.3+/-1.0 and 7.6+/-3.8 in the lap and open groups, respectively (p-value<0.001). There was no recurrence at 6 months follow-up.
Conclusion:
The paraumbilical hernia was commoner in females in the 7th decade of life and the obese. The laparoscopic repair had less pain in the immediate post-op period and a shorter hospital stay. Duration of surgery, though longer, and wound complications higher in the open group, were not statistically significant.

Key words: Paraumbilical hernia repair, the Asian population