Mesh plug versus onlay mesh repair of umbilical and paraumbilical hernia

Objectives: The aim of the study was to compare between two techniques of mesh placement in umbilical and paraumbilical hernias, that is, onlay (mesh on external oblique) versus mesh plug (in the defect), to establish the standard technique for treatment of such cases. Background: Hernias through the umbilical ring (umbilical hernia) and hernias adjacent to the umbilical ring (paraumbilical hernia) are common in the adult population, accounting for ~10–14% of all hernias. In spite of that, the optimal approach for umbilical and paraumbilical hernias is still under discussion. Patients and methods: This prospective study included 40 consecutive adult patients with uncomplicated umbilical and paraumbilical hernias. The patients were divided into two groups. Group A (n = 20) was operated upon following the onlay mesh repair technique, and group B (n = 20) was operated upon by means of the mesh plug technique. All patients were evaluated regarding operative time and postoperative complications. Results were documented and statistically analyzed. Results: In this study, mesh plug technique in the treatment of umbilical and paraumbilical hernias reduced seroma formation after drain removal (which was higher in the onlay mesh group; P = 1.000), and postoperative recurrence (which was higher in the onlay mesh group; P = 1.000) in comparison with onlay mesh repair. Conclusion: Mesh plug repair is better than onlay hernioplasty according to the postoperative complications.