35-year lady presented with a swelling over bellybutton since few weeks. She first noticed it 3 months ago. The swelling used to appear and disappear spontaneously. She started getting pain after strenuous work or lifting heavy objects at home. She has two children aged three and six years both delivered a caesarean section. She was examined in out-patient department and diagnosed with umbilical hernia. The same was confirmed with a sonography. The ultrasound examination showed a 2.5 cm defect under the umbilicus with omentum and small bowel loops as contents. She was prescribed pain medication for SOS pain relief and advised for surgery. She was explained the various options available like open, laparoscopic, and robotic surgery – advantages and disadvantages of all three surgeries discussed in detail.
She decided to opt for Laparoscopic surgery for umbilical hernia. She underwent the necessary preoperative tests and fitness for surgery.
She was admitted three hours prior on the day of surgery early morning with a six-hour fasting window. She was given a test dose of the antibiotic and then, the full dose was given thirty minutes prior to surgery.
Under general anaesthesia, three cuts made – one was 10 mm and two were 5 mm. During the surgery, the small bowel and omentum were brought back into the abdominal cavity. The gap in the muscle was closed using sutures. A composite mesh was placed to overlap beyond the defect using four pre-tied sutures. Once these sutures were tied, additional fixation was done using fine pins – pins which are made of absorbable suture material.
After checking any bleeding, the procedure is completed. The cuts are closed with absorbable stitches and compression dressing. She was comfortable and discharged from the hospital on the next day