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Umbilical hernia repair, open, preperitoneal umbilical mesh plasty ("PUMP”-Repair) - general and visceral surgery
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Dissecting the hernia sac
Exposing the fascial margins 360°
Dissecting the preperitoneal space
Preparing the mesh
Positioning the mesh
Spread out the planar mesh in the preperitoneal space. Stitch the anchor sutures through the fascia and anchor them lightly with delicate absorbable epifascial clips.
Instead of using absorbable clip the mesh may also be anchored by stitching both tails of the sutures through the fascia and tying them anterior to the latter. Tying the knots loosely will help prevent postoperative pain. The technique presented in the video is the safer option.
Closing the fascial defect
Fixating the umbilicus and closing the wound