Umbilical hernia surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
Surgery for umbilical hernia is as follows:<ref name="urlHernia, Umbilical - PubMed - NCBI">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmed/29083594 |title=Hernia, Umbilical - PubMed - NCBI |format= |work= |accessdate=}}</ref><ref name="urlHernia, Pediatric Umbilical - PubMed - NCBI">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmed/29083740 |title=Hernia, Pediatric Umbilical - PubMed - NCBI |format= |work= |accessdate=}}</ref><ref name="KellyPonsky2013">{{cite journal|last1=Kelly|first1=Katherine B.|last2=Ponsky|first2=Todd A.|title=Pediatric Abdominal Wall Defects|journal=Surgical Clinics of North America|volume=93|issue=5|year=2013|pages=1255–1267|issn=00396109|doi=10.1016/j.suc.2013.06.016}}</ref> | |||
*Surgical repair for an uncomplicated umbilical hernia is done under general anesthesia as an outpatient procedure. | *Surgical repair for an uncomplicated umbilical hernia is done under general anesthesia as an outpatient procedure. | ||
**Small curvilinear incision is made into the skin crease of the umbilicus | **Small curvilinear incision is made into the skin crease of the umbilicus | ||
Revision as of 14:29, 22 January 2018
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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. Surgical repair for an uncomplicated umbilical hernia is done under general anesthesia as an outpatient procedure. Mesh implantation include bridging the defect and placing a preperitoneal mesh with suture repair. Postoperative recovery is usually uneventful. Recurrence is seen in patients with elevated intra-abdominal pressures. Laparoscopic technique is reserved for large defects or recurrent umbilical hernias.
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
Surgery for umbilical hernia is as follows:[1][2][3]
- Surgical repair for an uncomplicated umbilical hernia is done under general anesthesia as an outpatient procedure.
- Small curvilinear incision is made into the skin crease of the umbilicus
- Sac is dissected free from the overlying skin and the fascial defect
- Ensures that no abdominal content are present prior to the repair
- Fascial defect is repaired with absorbable, interrupted sutures
- Skin is closed using subcuticular sutures with monocryl or vicryl
- In adults
- Small defects are closed after separation of the sac from the overlying umbilicus and surrounding fascia.
- Defects greater than 3 cm are closed using prosthetic mesh.
- No data shows clear advantages of one technique over another.
- Mesh implantation include bridging the defect and placing a preperitoneal mesh with suture repair.
- Laparoscopy is reserved for large defects or recurrent umbilical hernias.
- Postoperative recovery is usually uneventful.
- Recurrence is seen in patients with elevated intra-abdominal pressures.
References
- ↑ 1.0 1.1 "Hernia, Umbilical - PubMed - NCBI".
- ↑ 2.0 2.1 "Hernia, Pediatric Umbilical - PubMed - NCBI".
- ↑ Kelly, Katherine B.; Ponsky, Todd A. (2013). "Pediatric Abdominal Wall Defects". Surgical Clinics of North America. 93 (5): 1255–1267. doi:10.1016/j.suc.2013.06.016. ISSN 0039-6109.