Paraumbilical hernial repair by mesh plug under local anesthesia

Abstract

Back ground and objectives : The standard method of repair of paraumbilical hernia is by the mayo's technique,using a doublebreasted flap of the rectus sheath. The present study describes and evaluates the application of a prolen mesh plug in the paraumbilical repair.The use of a mesh plug in hernial repair is not a new concept with previous investigators yielding consistently excellent results in the repair of femoral and inguinal hernia. Patients and Methods: The study is prospective analysis of 36 patients having undergone PUH repair using the mesh plug technique in the period April 2004-April 2007. The study was conducted in Al-yarmouk teaching hospital .There were 16 males and 20 females with a median age of 50 years. ( range 30-80 years). Seventy percentage of the patient sample was obese (median BMI 30). whenever possible local anesthesia was used. Principal outcome measures were post –operative complications, recurrences,length of stay in hospital, analgesia, drain, return to normal activities and patient satisfaction. Results: post operative complications encountered included one case of seroma and a single case of wound infection. Ninety eight persent [35 ] of patients were satisfied with procedure.
Conclusion : Mesh plug repair can be performed with minimal post operative pain , minimal postoperative complications ,low recurrence rate and achieving excellent patient satisfaction. Prosthetic mesh plug repair under local anesthesia could become the standard treatment for PUH in adults.