The Liberec loop purse string hernioplasty, Omentum protected IPOM and Liberec umbilical lasso as possible alternative solutions for umbilical hernias – a multicentric observational study

Czech version

Authors: J. Škach ¹; L. Puszkailer ²; V. Blecher ¹; M. Valenta ³; T. Verner ⁴; Z. Rambousek ⁵; R. Harcubová ⁶
Authors‘ workplace: Kýlní centrum, Chirurgické oddělení, Krajská nemocnice Liberec, a. s. ¹; Chirurgicko-traumatologické oddělení, Nemocnice AGEL Šternberk ²; Chirurgické oddělení, Nemocnice Semily, Nemocnice MMN, a. s. ³; Chirurgické oddělení, Nemocnice Česká Lípa, Krajská nemocnice Liberec, a. s. ⁴; Chirurgické oddělení, Nemocnice Turnov, Krajská nemocnice Liberec, a. s. ⁵; Chirurgické oddělení, Nemocnice Frýdlant, Krajská nemocnice Liberec, a. s. ⁶
Published in: Rozhl. Chir., 2026, roč. 105, č. 7, s. 345-352.
Category: Original articles
doi: https://doi.org/10.48095/ccrvch2026345

Overview

Introduction: Umbilical hernia repair is one of the most common surgical procedures. A variety of methods have been developed for its treatment, both with and without a mesh, open, laparoscopically, and robotically. The goal of this work was to present some of our innovative repairs and their results.

Methods: The Liberec loop purse string hernioplasty (LLPSH) is a layered purse-string suture technique that allows for the suturing of a defect up to 10 cm without the use of a mesh, in cases where its use would be risky or contraindicated. The Omentum protected IPOM (OpIPOM) is a repair suitable for obese patients, where otherwise the use of a non-absorbable mesh intraperitoneally onlay would be indicated. This method allows for the safe use of an hydrophilic mesh instead of a hydrophobic one. The Liberec umbilical lasso (LUL) is an ultra-simple repair primarily indicated for small less symptomatic or asymptomatic hernias as part of another procedure.

Results: The LLPSH maintains a very low recurrence rate and SSI (2.7 and 8.2%, resp.) in our cohort of 108 patients. The average operating time for the OpIPOM in our group of 80 patients (40/40) was 30 min shorter compared to the Rives-Stoppa plastic surgery. Infection at the surgical site or complicated seroma occurred in 3 patients compared to 5 patients in the Rives-Stoppa group. Recurrence of hernia within 2 years of follow-up was the same for both methods (5%). The average duration of postoperative drainage was shortened by 1.8 days. The LUL improved the immediate postoperative esthetic effect and reduced the overall surgical time by approximately 10–15 min than other widely spread methods.

Conclusion: The LLPSH, OpIPOM and LUL are innovative surgeries for umbilical hernia, which do not aim to long-term replace proven and widely used surgeries for elective procedures on umbilical hernias. Despite their time efficiency, simplicity, and very good, albeit limited results, they maintain a relatively narrow indication spectrum.

Keywords:

Hernia – hernioplasty – navel

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