Umbilical hernia surgery
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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][3][4]
- 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][5][6][7]
- 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
- 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.
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References
- ↑ 1.0 1.1 "Hernia, Umbilical - PubMed - NCBI".
- ↑ 2.0 2.1 "Hernia, Pediatric Umbilical - PubMed - NCBI".
- ↑ Blay, Eddie; Stulberg, Jonah J. (2017). "Umbilical Hernia". JAMA. 317 (21): 2248. doi:10.1001/jama.2017.3982. ISSN 0098-7484.
- ↑ Kim, Lawrence T. (2017). "Complexity of the "Simple" Umbilical Hernia Repair". JAMA Surgery. 152 (5): 466. doi:10.1001/jamasurg.2016.5053. ISSN 2168-6254.
- ↑ 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.
- ↑ Tunio NA (2017). "Hernioplasty: Tension free mesh repair versus Mayos repair for umbilical hernias". J Pak Med Assoc. 67 (1): 24–26. PMID 28065949.
- ↑ Shankar, Divya A.; Itani, Kamal M. F.; O’Brien, William J.; Sanchez, Vivian M. (2017). "Factors Associated With Long-term Outcomes of Umbilical Hernia Repair". JAMA Surgery. 152 (5): 461. doi:10.1001/jamasurg.2016.5052. ISSN 2168-6254.