Perioperative management - Umbilical hernia, primary suture repair - general and visceral surgery
You have not purchased a license - paywall is active: to the product selection
Indications
According to the guidelines of the European Hernia Society and the Americas Hernia Society, umbilical hernia repair by direct suture is possible up to a hernia diameter of < 1 cm, unless there is obesity (BMI > 30) and/or rectus diastasis.
If a direct suture is considered, Spitzy's operation can be performed, which is presented in this article:- Incarceration (absolute indication!)
- any symptomatic hernia
- prevention of later incarcerations
- cosmetic
Contraindications
relative in:
- Cirrhosis of the liver with ascites
- Advanced malignancy
- Cardiopulmonary risk, e.g., heart failure (NYHA III and NYHA IV)
Preoperative diagnostic work-up
- Digital palpation!!
- Inspection: Protrusion, outpouching, pain on exertion
- In obese patients always ultrasound
- CT study only in special cases
Special preparation
- Depilation of the surgical field
- Marking the location of the hernia
- Patient fasting > 6 hours, no liquids > 3 hours
- Possibly pausing anticoagulants
Informed consent
- Secondary bleeding/hematoma
- Intestinal perforation
- Injury of adjacent structures
- Postoperative ileus
- Infection
- Thrombosis
- Embolism
- Recurrence (1-3%)
- Reoperation
- Impaired healing (5-10 %)
- Temporarily impaired postoperative exercise tolerance
- Chronic pain syndrome
Anesthesia
Positioning
Operating room setup
Special instruments and fixation systems
Postoperative management
Single Access
Access to this lecture
for 3 days
€4.99 inclusive VAT
webop-Account Single
full access to all lectures
price per month
for the modul: vascular surgery