Umbilical hernia surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
*Surgical repair for an uncomplicated umbilical hernia is done under general anesthesia as an outpatient procedure. | |||
**After local anesthesia, a small curvilinear incision is made into the skin crease of the umbilicus | |||
**the sac is dissected free from the overlying skin as well the fascial defect to ensure not abdominal content are present prior repair of the fascial defects. | |||
**The fascial defect is repaired with absorbable, interrupted sutures that are typically placed in a transverse plane. | |||
**The skin is closed using subcuticular sutures, either monocryl or vicryl. The postoperative recovery is usually uneventful. Recurrence is uncommon, but often seen in children with elevated intra-abdominal pressures. | |||
*In adults | |||
**Small defects are closed primarily after separation of the sac from the overlying umbilicus and surrounding fascia. | |||
**Defects greater than 3 cm are closed using prosthetic mesh. | |||
**No prospective data have conclusively found clear advantages of one technique over another. | |||
*Options for mesh implantation include bridging the defect and placing a preperitoneal underlay of mesh reinforced with suture repair. | |||
*The laparoscopic technique requires general anesthesia and is reserved for large defects or recurrent umbilical hernias. | |||
==References== | ==References== |
Revision as of 14:02, 22 January 2018
Umbilical hernia Microchapters |
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Umbilical hernia surgery On the Web |
American Roentgen Ray Society Images of Umbilical hernia surgery |
Risk calculators and risk factors for Umbilical hernia surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]
Overview
Umbilical hernia surgery is indicated when umbilical hernia is larger than 2cm, “elephant’s trunk” appearance, does not spontaneously close by 5 to 6 years of age, symptomatic, strangulation, or increases in size after the age of 1 to 2 years.
Indications
Umbilical hernia surgery is indicated in the following cases:[1][2]
- Larger than 2 cm
- “Elephant’s trunk” appearance
- Did not spontaneously close by 5 to 6 years of age
- Symptomatic
- Strangulation
- Hernia increases in size after the age of 1 to 2 years
Surgery
- Surgical repair for an uncomplicated umbilical hernia is done under general anesthesia as an outpatient procedure.
- After local anesthesia, a small curvilinear incision is made into the skin crease of the umbilicus
- the sac is dissected free from the overlying skin as well the fascial defect to ensure not abdominal content are present prior repair of the fascial defects.
- The fascial defect is repaired with absorbable, interrupted sutures that are typically placed in a transverse plane.
- The skin is closed using subcuticular sutures, either monocryl or vicryl. The postoperative recovery is usually uneventful. Recurrence is uncommon, but often seen in children with elevated intra-abdominal pressures.
- In adults
- Small defects are closed primarily after separation of the sac from the overlying umbilicus and surrounding fascia.
- Defects greater than 3 cm are closed using prosthetic mesh.
- No prospective data have conclusively found clear advantages of one technique over another.
- Options for mesh implantation include bridging the defect and placing a preperitoneal underlay of mesh reinforced with suture repair.
- The laparoscopic technique requires general anesthesia and is reserved for large defects or recurrent umbilical hernias.