Umbilical hernia, primary suture repair - general and visceral surgery

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date of publication: 30.11.2011
  • Chirurgische Praxis

    Dr. med.  Karl Heinz  Moser

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  • Skin incision

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    99-5

    Semicircular infraumbilical skin incision (Spitzy skin incision, “smiling incision”)

  • Hernia sac dissection

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    Transect the subcutis, free the hernia sac from the umbilicus and dissect the sac down to the fascial orifice. Most of the tissue prolapsing through the fascial orifice is preperitoneal epigastric fat.

  • Freeing the fascial margins

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    Free the entire margin of the fascia over a width of about 1cm.

  • Closing the hernia orifice

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    Invaginate the hernia sac with its attached preperitoneal fat and close the fascial orifice in transverse fashion with interrupted sutures (nonabsorbable suture 0/0 to 0/2).

  • Fixating the umbilicus

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    Refixate the umbilicus to the fascia.

  • Skin suture

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    Close the subcutis with interrupted sutures. Close the skin with subcuticular sutures. Adapt the wound with Steri-Strips. Dress and model the umbilical contour with a small swab. Adhesive dressing.