Umbilical Hernia and Diastasis Recti

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added:
5 years ago

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6098

Case description

The best of both worlds - OPEN&LAP Ventral Hernia Repair. This late morning we operated on an obese (110kg-1.63m) male, with recurrent umbilical hernia, diastasis and pickwick syndrome. We did not plicate the diastasis due to Pickwick. We started open, resected the huge umbilical hernia sac (A), did adhesiolisis (B), Easily inserted a covered mesh (18x25cm) by the umbilical defect (aprox 4cm) (C), and closed the defect with a 10mm trocar in the middle (D), in order to permit the insertion of another 10mm trocar very close to the ribs, under direct view (sorry in this institution we do not have 5mm optics, otherwise we would have use it). Then we did the lap repair fixing the mesh with one transumbilical stitch previously left by the umbilical wound and some tackers.

Full procedure was less than 40min with 24min of pneumo - short time for pneumo is really good for Obese Pickwick patients. We also did a generous local anesthesia at the umbilical fascia and skin to minimize post-op pain.

tags: Diastasis Recti umbilical hernia pickwick syndrome hernia sac adhesiolisis mesh