I often get asked whether the Shouldice or the Bassini is the best method for repair of umbilical hernias. This represents a misunderstanding about hernia repairs. The Shouldice and the Bassini are methods to repair inguinal hernias but have no place in the repair of umbilical hernias. For umbilical hernia repair, there are two basic methods. The first is a pure tissue repair and the second is the use of mesh.
Pure tissue repair uses sutures to close the hole. This can be a primary closure or a layered closure such as pants over vest. The pure tissue repair has the best results for small hernias (less than 3 to 5cm) and in patients with a normal BMI.
Unfortunately, for large umbilical hernias mesh has to be used to get the defect closed. The mesh can be placed to cover the hernia or placed on the peritoneal side of the hernia. And as we all know, the mesh can be associated with chronic pain and rejection problems.
Consult with a surgeon familiar with all the technical aspects of repair and get the type of repair tailored to your situation.