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Umbilicus is the point where the strongest tension is applied in the abdominal wall.
So to prevent recurrence, large umbilical hernia repair may need Goretex cloth or other material for reinforcement.
Good news is there would be little problem of using foreign material in umbilical hernia repair, if small size material is used and fixed with a thin suture material.Sadly I haven’t submitted my result to international surgical Journal yet.
I am preparing for it.