Umbilical hernia, direct suture

Anatomy Perioperative management Technique Complications Evidence Total Video

Skin Incision

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Skin incision below the navel, semicircular (Spitzy incision, smiling incision).
Preparation of the Hernia Sac

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Transection of the subcutis and detachment of the hernia sac from the umbilicus, exposing it up to the fascial ring.
Note: The detachment of the thin umbilical skin is performed without electrocautery!
Displaying the Fascia Edges

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Through the fascial gap, predominantly preperitoneal epigastric fat protrudes. The fascial gap is carefully prepared epifascially.
Closure of the Hernial Orifice

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Invagination of the hernial sac or preperitoneal fat tissue and transverse closure of the hernial gap with interrupted sutures (non-absorbable suture 0-0 or 2-0).
Fixation of the Navel

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Refixation of the navel to the fascia with an absorbable suture.
Skin Suture

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Closure of the subcutis with interrupted sutures. Skin closure by intracutaneous suture. Wound adaptation with Steri-Strips. Shaping of the navel with a small swab. Adhesive dressing.

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Umbilical hernia, direct suture

Skin Incision

Preparation of the Hernia Sac

Displaying the Fascia Edges

Closure of the Hernial Orifice

Fixation of the Navel

Skin Suture