Umbilical Hernia

• Failure of closure of umbilical ring
• Common in males, and premature infants
• Acquired in adults with cirrhosis, obesity, ascites, malnutrition
• Repairs:
      - Mayo "vest-over-pants"
      - Primary mass closure
• Current trends in repair include mesh implantation into the properitoneal space to obtain a tension-free closure of the umbilical ring and remain extra-peritoneal. This is my personal choice for repair of umbilical hernias greater then 2 cm in diameter