evidence - Umbilical hernia, primary suture repair

  1. Literature summary

    Gold standard for this operation is the Spitzy repair by direct suture as described in this article.


      • Diameter of hernia orifice < 3cm
      • Symptomatic umbilical hernia, incarceration
      • In newborns umbilical hernia is physiological until umbilical scarring is complete. Since in 98% of cases the umbilical hernia will close spontaneously by the end of the 2ndyear (very little danger of incarceration during this time) surgery is not indicated before that time.


      • Ascites
      • Peritoneal metastasis
      • General inoperability

    The recurrence rate correlates with:

      • BMI <30 recurrence rate: 8%, BMI>30 recurrence rate: 32%
      • Diameter of hernia orifice: The recurrence rate in hernia orifices up to 1cm was 6.3%; in diameters 1-2cm 4.1%; in hernia orifices 2-3cm 14.3%; in diameters 3-4cm 25.0%; and in hernia orifices larger than 4cm 54.5%.
        Closure of the hernia orifice with mesh augmentation is indicated in patients with a BMI >30 and a hernia orifice > 3cm.
References on this topic

Dig Liver Dis. 2011 Dec;43(12):991-5. Epub 2011 Aug 26.Management of umbilical hernia complicated w

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  • literature search

    Literature search on the pages of pubmed.