Laparoscopic Versus Open Umbilical Hernia Repair

BACKGROUND The use of prosthetic material for open umbilical hernia repair has been reported to reduce recurrence rates. The aim of this study was to compare outcomes after laparoscopic versus open umbilical hernia repair. METHODS We reviewed all umbilical hernia repairs performed from November 1995 to October 2000. Demographic data, hernia characteristics, and outcomes were compared. RESULTS Of the 76 patients identified, 32 underwent laparoscopic repair (LR), 24 primary suture repairs (PSR), and 20 open repairs with mesh (ORWM). Preoperative characteristics were similar between groups. Hernia size was similar between LR and ORWM groups, and both were larger than that in the PSR group. ORWM compared with the other techniques resulted in longer operating time, more frequent use of drains, higher complication rates, and prolonged return to normal activities (RTNA). The length of stay (LOS) was longer in the ORWM than in the PSR group. When compared with ORWM, LR resulted in lower recurrence rates. LR resulted in fewer recurrences in patients with previous repairs and hernias larger than 3 cm than in both open techniques. CONCLUSIONS LR results in faster RTNA, and lower complication and recurrence rates compared with those in ORWM. Patients with larger hernias and previous repairs benefit from LR.