COMPARATIVE ANALYSIS OF SURGICAL APPROACHES FOR PARAUMBILICAL HERNIA REPAIR: MAYO REPAIR VS. MESH REPAIR IN THE INDIAN POPULATION

Abstract

Introduction:

Paraumbilical hernias pose significant health risks if left untreated, particularly in populations with high prevalence rates due to risk factors such as obesity and multiparity. Surgical repair is the standard treatment, with options including Mayo repair and mesh repair. Debate persists regarding the optimal approach, especially in the Indian population.

Objectives:

This study aimed to compare outcomes between Mayo repair and mesh repair for paraumbilical hernias in the Indian population, focusing on recurrence rates and patient outcomes.

Materials & Methods:

Conducted across two Indian centers, this multicentric study utilized a combined prospective and retrospective method between June 2020 and June 2022. Fifty patients meeting inclusion criteria underwent either Mayo repair or mesh repair. Clinical history, physical exams, preoperative investigations, and surgical procedures were documented.

Results:

Among 58 patients, predominantly females, both techniques showed efficacy in reducing symptoms. Mesh repair had no recurrences, while one recurrence occurred with Mayo repair. Complications included surgical site infections (more common in mesh repair) and seroma formation (more common in Mayo repair).

Discussion:

Risk factors for paraumbilical hernias, such as multiparity and obesity in females and smoking in males, were evident. While defect sizes did not significantly differ between repair groups, mesh repair tended to address larger defects. Complications varied between techniques, with mesh repair showing a higher risk of surgical site infections and Mayo repair associated with seroma formation. Recurrence rates favored mesh repair, though not statistically significant.

Conclusion:

This study underscores the importance of patient-specific considerations in hernia repair selection. Mesh repair may offer advantages in preventing recurrence but carries a higher risk of surgical site infections. Mayo repair, conversely, may be suitable for smaller defects despite a higher seroma risk. Further research with larger cohorts is warranted to corroborate these findings.