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

Anatomy Perioperative management Technique Complications Evidence Total Video

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.