question-icon

What causes umbilical hernia prior to laparoscopic cholecystectomy?

default
Posted on Mon, 11 May 2015
Question: I am going to have laparoscopic cholecystectomy, upon seeing the surgeon who is going preform the operation I was told I had an umbilical hernia. I believe this is from my tubal ligation I had done almost four years ago. My question is why did no other doctor catch this, and am I at any extra risk when I have my laparoscopic cholecystectomy via belly button incision?
doctor
Answered by Dr. Vivek Chail (32 minutes later)
Brief Answer:
Many patients get lap cholecystectomy and umbilical hernia surgery together

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. The umbilical hernia might have been small in the beginning and that is the reason it was not picked up till your surgeon did a careful clinical examination.

2. Umbilical hernias are routinely diagnosed on ultrasound and CT scan and the symptoms are that the patient comes with a prominent umbilicus during coughing or applying pressure during passing stool.

3. Umbilical hernia with laproscopic cholecystectomy have been dealt together in many patients and medical research has been done on the topic. There is a research on 64 patients who had laproscopic cholecystectomy and umbilicar hernia repair surgery done at the same time. Please find detailed information below

(i) In one study, 64 out of 745 that is 8.6 percent patients scheduled for laproscopic cholecystectomy also underwent umbilical hernia repair surgery at the same time.

(ii) Laproscopic cholecystectomy surgery was followed by umbilical hernia repair using any one of the standard techniques including
a. using primary suture in 50 percent patients,
b. Mayo repair and in 28.1 percent patients
c. flat mesh-based repair (usually for hernias more than 4 cm) in 21.9 percent patients

4. Using the above techniques, recurrence rate was
(i) 9.4 percent when using primary suture
(ii) 5.6 percent when using Mayo repair technique
(iii) nil recurrence with mesh repair.

5. Therefore it is seen that mesh repair has the best outcomes with nil recurrence rate in the research quoted above.

6. There is no significant extra risk in doing laproscopic cholecystectomy and umbilical hernia surgery together. There was no threat to life in any of the patients who underwent the above procedure described above.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6850 Questions

premium_optimized

The User accepted the expert's answer

Share on
What causes umbilical hernia prior to laparoscopic cholecystectomy?

Brief Answer: Many patients get lap cholecystectomy and umbilical hernia surgery together Detailed Answer: Hi XXXX, Thanks for writing in to us. I have read through your query in detail. Please find my observations below. 1. The umbilical hernia might have been small in the beginning and that is the reason it was not picked up till your surgeon did a careful clinical examination. 2. Umbilical hernias are routinely diagnosed on ultrasound and CT scan and the symptoms are that the patient comes with a prominent umbilicus during coughing or applying pressure during passing stool. 3. Umbilical hernia with laproscopic cholecystectomy have been dealt together in many patients and medical research has been done on the topic. There is a research on 64 patients who had laproscopic cholecystectomy and umbilicar hernia repair surgery done at the same time. Please find detailed information below (i) In one study, 64 out of 745 that is 8.6 percent patients scheduled for laproscopic cholecystectomy also underwent umbilical hernia repair surgery at the same time. (ii) Laproscopic cholecystectomy surgery was followed by umbilical hernia repair using any one of the standard techniques including a. using primary suture in 50 percent patients, b. Mayo repair and in 28.1 percent patients c. flat mesh-based repair (usually for hernias more than 4 cm) in 21.9 percent patients 4. Using the above techniques, recurrence rate was (i) 9.4 percent when using primary suture (ii) 5.6 percent when using Mayo repair technique (iii) nil recurrence with mesh repair. 5. Therefore it is seen that mesh repair has the best outcomes with nil recurrence rate in the research quoted above. 6. There is no significant extra risk in doing laproscopic cholecystectomy and umbilical hernia surgery together. There was no threat to life in any of the patients who underwent the above procedure described above. Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek