Umbilical hernia
| Anesthesia type |
General |
|---|---|
| Airway |
ETT |
| Lines and access |
PIV x 1 usually sufficient |
| Monitors |
Standard monitoring; 5-lead ECG, Temperature |
| Primary anesthetic considerations | |
| Preoperative | |
| Intraoperative |
Muscle relaxant for large hernias |
| Postoperative |
Avoid coughing and straining on emergence; abdominal binder is placed after procedure |
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| User likes | 0 |
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
| System | Considerations |
|---|---|
| Airway | |
| Neurologic | |
| 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
| 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.