Background: Para-umbilical hernia repair (PUHR) combined with LC result in longer operating time, longer anesthesia, and risk of increased blood loss. But it has the advantages of single hospital stay, single anesthesia exposure, less post-operative pain and morbidity, early return to work, better cosmesis and more convenient , efficacy and cost effective for the patient.
Objective: To evaluate the selected repair methods for para-umbilical hernias that already exist or are encountered incidentally and to present data regarding potential problems that may occur during laparoscopic cholecystectomy.
Patients and Methods: During period of January 2017 to January 2019, laparoscopic cholecystectomy was attempted in 25 patients suffering from chronic calcular cholecystitis accompanied by para-umbilical hernia, patients were assigned to two groups according to occurrence of recurrence. A retrospective analysis of parameters, including patient demographics, laboratory values, radiologic data, and intraoperative findings, was performed.
Results: The operating time, postoperative pain, length of hospital stay, wound infection and the time needed for return to work were less in patients without recurrence than patients with recurrence. Recurrence occurred in cases with BMI 35.5±8.08, patient with comorbidities (DM and hypertension) and size of the defect 2.4±.07 cm. Cases with recurrence have longer operational time and hospital stay than cases without recurrence and take more days to return to work. Cases with recurrence have also other complication such as hematoma and wound infection. There was a moderate positive correlation between BMI and both operating time and length of hospital stay. There was strong positive correlation between size of hernia and both operating time and length of hospital stay. There was a strong positive correlation between comorbidity and both operating time and length of hospital stay.
Conclusion: Para-umbilical hernia repair combined with laparoscopic cholecystectomy resulted in longer operating time, longer anesthesia, and risk of increased blood loss. But it has the advantages of single hospital stay, single anesthesia exposure, less postoperative pain and morbidity, early return to work, better cosmesis and more convenient, efficacy and cost effective for the patient. However, the outcomes of the para-umbilical defect repair with mesh after laparoscopic surgeries appeared to be better for either obese or non-obese patients than primary suture techniques in recurrence rates.