Umbilical hernia repair, open, preperitoneal umbilical mesh plasty ("PUMP”-Repair) - general and visceral surgery

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Skin incision

Semicircular skin incision along the right lateral margin of the umbilicus.
Dissecting the hernia sac

With delicate dissecting scissors free the hernia sac all around from its adhesions with the subcutaneous tissue without opening it.
Exposing the fascial margins 360°

360° epifascial dissection with exposure of the fascial margins, followed by freeing the hernia sac from these margins.
Dissecting the preperitoneal space

Carefully free the peritoneum digitally from the posterior lamina of the fascia; this will open the preperitoneal space 360° around the fascial defect over a length of 3–5cm.
Preparing the mesh
Positioning the mesh
Closing the fascial defect
Fixating the umbilicus and closing the wound

Skin incision
Dissecting the hernia sac
Exposing the fascial margins 360°
Dissecting the preperitoneal space
Preparing the mesh
Positioning the mesh
Closing the fascial defect
Fixating the umbilicus and closing the wound

date of update: 14.02.2017

date of publication: 29.04.2013

Prof. Dr. med. Markus Heiss
Krankenhaus Merheim

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