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Umbilical hernia repair - series

Normal anatomy:
Normal anatomy

The umbilicus ("belly button") is in the center of the lower abdomen. It is the site through which vessels which provide nutrients to the fetus from the mother during development penetrate the fetal abdominal wall.



Indications:
Indications

Umbilical hernias are fairly common. They are obvious at birth and are caused by a small defect in the abdominal muscles which allows a portion of the peritoneum (lining of the abdominal cavity) to protrude, and push the umbilicus outward. This is more obvious when the infant cries and the increased pressure results in more visible bulging. The defect is not usually treated surgically. In most cases, by age 3 the umbilical hernia shrinks and closes without treatment.

The indications for umbilical hernia repair include:

  • incarcerated (strangulated) umbilical hernia
  • defects not spontaneously closed by 4 to 5 years of age
  • children under 2 with very large defects unacceptable to parents for cosmetic reasons


Incision:
Incision

General anesthesia is used. A curved incision is made under the umbilicus.



Procedure:
Procedure

The hernia sac is identified and dissected from the underlying tissues, and cut out. The underlying tissues are then closed with strong nonabsorbable sutures. Skin edges are held with paper tape (steri-strips). The surgical scar should be hidden in the umbilical depression.



Aftercare:
Aftercare

Children can usually go home within one to two days of an umbilical hernia repair. Recurrence is rare.




Review Date: 1/29/2013
Reviewed By: John A. Daller, MD, PhD, Department of Surgery, Crozer-Chester Medical Center, Chester, PA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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