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Invited Commentary
November 2013

Laparoscopic Umbilical and Epigastric Hernia Repair: The Procedure of Choice?

Author Affiliations
  • 1North Florida/South Georgia Veterans Health System, Department of Surgery, University of Florida College of Medicine, Gainesville
JAMA Surg. 2013;148(11):1049. doi:10.1001/jamasurg.2013.3607

Ventral hernia repair is one of the more common operations performed by general surgeons in the United States, with more than 350 000 operations performed annually.1 Ventral hernias are broadly divided into 2 groups: incisional and primary hernias such as umbilical and epigastric hernias, respectively. Although ventral hernias are mostly thought of as incisional hernias, data from American College of Surgeons National Surgical Quality Improvement Program suggest that the majority of ventral hernias repaired are actually primary hernias.2 There remains considerable debate about which is the best approach to repair primary ventral hernias, the laparoscopic or the open technique, and despite the frequency of the clinical condition, a paucity of good evidence to guide surgical decision making.