# repair of umbilical and right lower quadrant ventral hernia



## ksb0211 (Jun 28, 2012)

Just wanted to make sure I'm reading this correctly.  Hoping for other opinions on this one.  Thanks.

PREOPERATIVE DIAGNOSIS
Abdominal pain, rule out right lower quadrant hernia.

POSTOPERATIVE DIAGNOSIS
1.  Right lower quadrant hernia, ventral hernia
2.  Umbilical hernia.

OPERATION PERFORMED
Diagnostic laparoscopy with open repair of umbilical and right lower quadrant ventral hernia.

DESCRIPTION OF PROCEDURE
The patient brought to the operating room after attainment of sufficient general anesthesia, she was pretreated with antibiotics and prepped and draped in the usual sterile fashion.  We made a cutdown incision to gain access to the abdominal cavity in the left upper quadrant, introduced a trocar and a 5 mm port.  Looking inside, we could see that there was a clear cut defect in the right lower quadrant which did not appear to be an inguinal hernia.  I went ahead and left her insufflated, injected.  This was a relatively small defect, probably about 3 cm in diameter, opened and then carried out a primary repair of this hernia with interrupted sutures of figure-of-8 fashion of 2-0 Ethibond.  Once that was done, we had completely closed the hernia then we closed over the top of it was external oblique fascia which we closed with 2-0 Vicryl.  Went back up to the umbilicus, there was a defect in this area and closed that defect.  We actually removed the preperitoneal fat, left us with about a 1 cm umbilical defect which we closed with 2-0 Ethibond sutures and then closed that with skin staples in all locations.

The patient tolerated the procedure quite well.


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