Jessica.Milin: Created page with "{{Infobox surgical procedure | anesthesia_type = General | airway = ETT | lines_access = PIV x 1 usually sufficient | monitors = Standard monitoring; 5-lead ECG, Temperature | considerations_preoperative = | considerations_intraoperative = Muscle relaxant for large hernias | considerations_postoperative = Avoid coughing and straining on emergence; abdominal binder is placed after procedure }} A protrusion of the intestine and omentum through an abdominal wall weakness..."

2022-04-05T00:40:50Z

Created page with "{{Infobox surgical procedure | anesthesia_type = General | airway = ETT | lines_access = PIV x 1 usually sufficient | monitors = Standard monitoring; 5-lead ECG, Temperature | considerations_preoperative = | considerations_intraoperative = Muscle relaxant for large hernias | considerations_postoperative = Avoid coughing and straining on emergence; abdominal binder is placed after procedure }} A protrusion of the intestine and omentum through an abdominal wall weakness..."

New page

{{Infobox surgical procedure
| anesthesia_type = General
| airway = ETT
| lines_access = PIV x 1 usually sufficient
| monitors = Standard monitoring; 5-lead ECG, Temperature
| considerations_preoperative =
| considerations_intraoperative = Muscle relaxant for large hernias
| considerations_postoperative = Avoid coughing and straining on emergence; abdominal binder is placed after procedure
}}

A protrusion of the intestine and omentum through an abdominal wall weakness at the umbilical cord.

The procedure can be performed as open or laparoscopic approach. The herniated tissue and intestine are gently pushed back through the hole in the abdominal wall.

Mesh is used to help close and supplement large umbilical hernias. It extends well beyond the edges of the defect to reduce pressure on the hernia opening.

== Overview ==

=== Indications: ===
Umbilical hernia

=== Surgical procedure ===

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
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|-
|Neurologic
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|-
|Cardiovascular
|
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===

=== Induction and airway management ===

* GA with ETT; muscle relaxants will be used for larger umbilical hernias
* Local anesthetic and sedation may be used for very small umbilical hernias

=== Positioning ===
Supine

=== Maintenance and surgical considerations ===

=== Emergence ===
Avoid coughing or straining on emergence

== Postoperative management ==

=== Disposition ===

=== Pain management ===
Post-op pain score: 3-5

* Acetaminophen
* Ketorolac
* Surgical infiltration of local anesthetic

=== Potential complications ===

* Wound infection or infection involving mesh
* Dehiscence with profound coughing during emergence
* Recurrence of hernia
* DVT
* Postoperative ileus seromas

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==
Jaffe, Richard A. Anesthesiologist's Manual of Surgical Procedures., 2012.

Macksey, Lynn Fitzgerald. Surgical Procedures and Anesthetic Implications: A Handbook for Nurse Practice. Sudbury, MA: Jones & Bartlett Learning, 2012.
[[Category:Surgical procedures]]

Umbilical hernia - Revision history