Umbilical reconstruction after repair of large umbilical hernia: the “lazy-M” and omega flaps

A novel laparoscopic technique for the repair of pediatric umbilical and epigastric hernias

“…The following equipment is needed [2]: 3-mm trocars, 308 telescope that is 2.7 mm in diameter, knot pusher, monopolar hook cautery, Maryland dissector, 3-mm needle holder, 3-mm hook scissor, and 2-0 Ethibond (Ethicon, Cincinnati, Ohio) on an SH needle. A 75-mm Veress needle inserted between the left iliac crest and costal margin (in line with the umbilicus) at the level of the anterior to midaxillary line is used to establish a pneumoperitoneum of 12 torr.…”

“…Umbilical hernia repair involves either a circumumbilical or intraumbilical skin incision, dissection of the hernia sac, and suture closure of the fascia. Proboscoid umbilical skin can be left to contract on its own, although some authors have suggested minimizing the excessive skin by a variety of suture and/or flap methods [1][2][3][4][5][6][7][8][9][10][11]. The goal of surgery for these hernias is to definitively close the fascial defect while optimizing the aesthetic result of the wound and minimizing complications.…”

Umbilicoplasty in children with huge umbilical hernia

“…To restore an umbilicus aesthetically near to the natural one, many techniques of umbilicoplasty have been described. [3][4][5][6] We herein report the results of umbilicoplasty with our technique, which is simple and permits to reconstitute a regular and aesthetic umbilicus.…”

Umbilicoplasty with 3 triangular skin flaps and excised diamond-shaped skin flap

“…Some authors have reported modified techniques that can be used in patients with large umbilical hernia [1][2][3]. However, these techniques sometimes cause unsatisfactory results, particularly postoperative infraumbilical flattening and disappearance of the umbilical depression.…”

“…Procedures are usually performed through a curved infraumbilical incision along the umbilical ring [1][2][3]. However, in cases of large umbilical hernia, these surgical techniques cannot diminish the diameter of the umbilicus, and unsatisfactory results are sometimes encountered, such as remnant of a large umbilical ring, postoperative flattening, or disappearance of the umbilical depression.…”