Umbilical hernia repair, open, preperitoneal umbilical mesh plasty (“PUMP” repair)

Anatomy Perioperative management Technique Complications Evidence Total Video

Content

Skin incision
Preparation of the Hernia Sac
Circular Exposure of the Fascial Edges
Preparation of the preperitoneal space
Preparing the Mesh
Placing the Mesh
Closure of the Fascial Defect
Refixation of the umbilicus; Wound closure

Authors

Date

date of publication: 29.04.2013
date of update: 10.04.2024

Skin incision

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A semicircular skin incision is made at the right lateral edge of the umbilicus.
Preparation of the Hernia Sac

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Using fine dissecting scissors, the hernia sac is circularly dissected from the subcutaneous tissue without opening it and detached from the umbilicus.
Note: The detachment of the thin umbilical skin is performed without electrocoagulation!
Circular Exposure of the Fascial Edges

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Circular epifascial preparation with initial exposure of the fascial edge, then detachment of the hernia sac from the fascial defect..
Preparation of the preperitoneal space

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Careful digital detachment of the peritoneum from the posterior fascial sheath, thereby opening the preperitoneal space in all directions over a distance of 3-5 cm around the fascial defect.