Herniorrhaphy (Hernia Repair)

After induction of GA and painting-draping, a small curvilinear incision, just within the limit of umbilicus, either its superior or inferior aspect is made. The contents of the hernia sac are reduced manually.

The incision is deepened to expose the hernial sac. The hernial sac is dissected free all around from the adjacent tissues. If the contents are still within the hernia sac, they are reduced with small opening within the hernia sac towards umbilical end. The hernia sac is freed from its umbilical attachment and is closed at the peritoneal surface.

The defect within the rectus sheath is assessed and the flaps of the rectus sheath are mobilized adequate. The superior and inferior flaps of rectus sheath are closed in two layers by strong vicryl or prolene sutures (in the fashion of double breasting). The dissected umbilicus is restructured (umbilicoplasty) and the incision is closed applying subcuticular suture for skin.