Laparoscopic transabdominal preperitoneal approach for umbilical hernia with rectus diastasis

Abstract

Introduction

Rectus diastasis, when coexistent with umbilical hernia, can benefit from mesh-based repair of the midline. Laparoscopic correction of an umbilical hernia involves the placement of a mesh in the peritoneal cavity, but this comes with the risk of bowel complications. However, newly developed dual-sided composite meshes have helped to reduce this risk.

Materials and Surgical Technique

Four men and three women with umbilical hernia and rectus diastasis were treated with laparoscopic transabdominal preperitoneal repair. Composite mesh with a hydrophilic 3-D polyester textile on the parietal side and an absorbable collagen barrier on the peritoneal side were placed in the preperitoneal pocket after hernial sac reduction. Mean hernia size was 2.5 cm, and no recurrences were observed during the mean follow-up period of 9.2 months.

Discussion

The laparoscopic transabdominal preperitoneal approach for umbilical hernia and rectus diastasis may be a safe surgical option when trying to avoid potential complications related to intra-abdominal mesh positioning.

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