Primary Umbilical Hernia Repair: Does Suture Type Matter?

Document Type

Conference Proceeding

Publication Date

4-2025

Publication Title

Surgical Endoscopy

Abstract

Introduction: Umbilical hernias are a common surgical pathology, with an estimated prevalence in 23–50 percent of people. Small umbilical hernias are generally treated with primary suture repair. The risk of recurrence following these repairs is 4.9 to 27%. A variety of suture types and repair techniques are used for these hernias with little evidence to suggest which suture and technique provides the lowest risk of recurrence. There has also been very little data on absorbable suture repairs, yet most midline laparotomies are closed as such. The primary goal of our study is to evaluate recurrence rates between primary repairs with braided and monofilament suture. We will also analyze permanent vs. absorbable monofilament repairs.

Methods: We conducted a retrospective review of primary umbilical hernia repairs in patients over the age of 18 performed at a single institution by a group of ten surgeons from November 2018 through November 2023. The primary outcome was comparison of recurrence rates between braided and monofilament suture. Secondary outcomes include recurrence rate of monofilament absorbable vs. permanent, recurrence rate by repair method, and rates of wound complications. Patient operative notes were evaluated to ensure that they met inclusion criteria, suture type, and repair methods were abstracted. Recurrence was defined either radiographically or those requiring reoperative repair. Wound complications were also recorded.

Results and Discussion: We evaluated 879 patients that met inclusion criteria with a mean age of 51.1, mean BMI 29.6, mean CCI 1.67, and 77.7% male. 86.8% of patients were closed with braided (Ethibond) suture and 13.2% were closed with monofilament (PDS or Prolene). Rate of recurrence with braided was 4.09% vs. 5.41% with monofilament suture with no significant difference in rate of recurrence identified using Pearson Chi-Square test. Breakdown of PDS vs. Prolene showed recurrence of 3.8% and 6.7%, respectively. Secondary outcomes are currently being analyzed. Our study demonstrates that suture type in primary umbilical hernia repairs does not significantly change rate of recurrence.

Volume

39

Issue

Suppl 1

First Page

S59

Last Page

S59

Comments

SAGES Annual Meeting, March 12–15, 2025, Long Beach, CA

DOI

10.1007/s00464-025-11688-

ISSN

1432-2218

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