Umbilical hernia, primary suture repair

  1. Skin incision

    Skin incision

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

  2. Hernia sac dissection

    Hernia sac dissection

    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.

  3. Freeing the fascial margins

    Freeing the fascial margins

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

Closing the hernia orifice

Invaginate the hernia sac with its attached preperitoneal fat and close the fascial orifice in tran

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