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

  1. Skin incision

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    Skin incision
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    Semicircular skin incision along the right lateral margin of the umbilicus.

  2. Dissecting the hernia sac

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    Dissecting the hernia sac
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    With delicate dissecting scissors free the hernia sac all around from its adhesions with the subcutaneous tissue without opening it.

  3. Exposing the fascial margins 360°

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

  4. Dissecting the preperitoneal space

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    Dissecting the preperitoneal space
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    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

Trim the mesh (Tutomesh® in the video example) to a size of 6×6cm and then arm the corners of the m

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