Button hole hernioplasty: A new technique for treatment of umblical hernia in cirrhotic patients. A prospective follow up study

• The operative time was significantly influenced by coagulation profile of cirrhotic patients as well the amount of ascites.
• Postoperative course of the patients was influenced by the severity of liver affection.
• The final outcome of treatment was influenced by severity of liver affection.
• Associated co morbidities had no significant effect on results.

BackgroundSurgical treatment of umbilical hernia in cirrhotic patients is still an interesting topic in many studies to achieve the best method of treatment. These patients are liable to many surgical and medical risks.Aimsto evaluate the surgical outcome as well as the postoperative course of Button hole hernioplasty as a simple, safe, and effective new technique for hernia repair in cirrhotic patients.MethodsForty cirrhotic patients with uncomplicated umbilical hernia were included in this study through collaboration between Departments of General Surgery and Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, during one year period. Patients were categorized according to the severity of liver cirrhosis into three groups (A, B, and C). Patients were subjected to an elective hernioplasty after adjustment of the disturbed medical and biochemical factors.ResultsThere was a significant difference in operative time, hospital stay, and prothrombine (time and concentration) among the three groups (p < 0.05). The three parameters were longest in group C when compared to the other two groups. No severe complications were recorded except in only one case. Also, no recurrence, no morbidities or deaths were recorded after 6 months follow-up.ConclusionsButton hole hernioplasty is a new simple surgical technique for treatment of umbilical hernia in cirrhotic patients with no significant complications.