StayCurrentMD
Epigastric Hernia
Everything in the library about epigastric hernia — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Not yet categorized
3 items
Laparoscopic Epigastric Herniorrhaphy-Case and Discussion: Pediatric Surgery...
Watch →
During the Pediatric Surgery Tricks of the Trade and Difficult Cases: Innovative Solutions to Common Problems Course in 2013, Dr. Cristobal Abello Munarriz introduceslaparoscopic epigastric herniorrhaphy, narrated in English by Dr. Todd Pon
video14:58 · Sep 2018
Tricks - Laparoscopic Epigastric Herniorrhaphy
Watch →
This segment displays a presentation of laparoscopic epigastric herniorrhaphy, followed by a comprehensive discussion discussion.
video15:20 · Nov 2018
Update Course Rewind: Spontaneous Pneumothorax 2021
Watch →
We've seen a lot of recent updates about the management of primary spontaneous pneumothoraces. At the recent 2021 Pediatric Surgery Update Course, Dr. Ronnie Sullins reviewed the latest literature. And now we're giving you the highlights in
video · Oct 2021
Summaries and takeaways+ Show
The doctors in this collection+ Show
All expert statements+ Show
Every expert statement below comes from the recorded discussions, with its speaker and moment.
Laparoscopic Epigastric Herniorrhaphy-Case and Discussion: Pediatric Surgery...
The case involved a 5-year-old girl with epigastric swelling and tenderness that had not reduced for 6 months.
host_summary0:00 ↗
The technique used a 3mm umbilical port and 3mm percutaneous instruments in the left anterior axillary line.
host_summary0:30 ↗
Finger pressure on the abdominal wall hernia bulge was used to identify the hernia site laparoscopically.
host_summary1:00 ↗
The peritoneum was opened, fatty tissue removed, and the hernia ring exposed and closed with interrupted percutaneous 3-0 PDS sutures.
host_summary1:30 ↗
The laparoscopic approach avoids a non-cosmetic incision and scar in the epigastric region.
host_summary2:20 ↗
Combined optics with a working channel allow repair through the umbilicus alone, using endoclose or percutaneous sutures tied subcutaneously.
clinical2:58 ↗
True epigastric hernias contain only preperitoneal fat and are extraperitoneal, not full-thickness defects with omentum or peritoneal sac.
clinicalSharif3:35 ↗
Working on the anterior abdominal wall through the umbilicus is difficult due to poor working angle.
opinionSharif4:00 ↗
Dr. Abello confirmed the hernia was a true epigastric hernia with fat, not omentum.
host_summaryTodd Ponsky4:34 ↗
The surgeon opened the peritoneum from inside, accessed the preperitoneal space, and pulled down preperitoneal fat that was residing in the hernia space.
clinical4:43 ↗
Finger pressure on the outside pushed the hernia contents inward to aid laparoscopic identification.
clinicalKathy5:06 ↗
For teenage girls with unsightly epigastric hernias, the laparoscopic technique is worth considering for cosmetic reasons.
opinionKathy5:06 ↗
Some small epigastric hernias in 3-4 year olds enlarge significantly by age 10, with increased preperitoneal fat and larger defects.
clinicalSharif5:31 ↗
The natural history of epigastric hernias is to enlarge over time.
clinicalSharif5:55 ↗
Repairing epigastric hernias when small is a minor procedure.
opinionSharif5:55 ↗
Asymptomatic epigastric hernias may enlarge into adulthood, especially after pregnancy in females, potentially requiring mesh rather than primary closure.
clinicalTodd Ponsky6:01 ↗
Many epigastric hernias remain totally asymptomatic and small in size throughout life.
clinicalJeff6:34 ↗
Epigastric hernias are not a significant health concern like inguinal hernias.
opinionJeff7:00 ↗
Some women with epigastric hernias experience significant pain during pregnancy.
clinicalJeff7:10 ↗
Inferior epigastric hernias can be repaired through a periumbilical incision by moving the skin incision upward.
clinicalKathy7:23 ↗
Dr. Abello does not repair all asymptomatic epigastric hernias but does repair them in female patients due to pregnancy concerns.
host_summary7:49 ↗
Some large adult epigastric hernias require mesh repair.
clinicalTodd Ponsky7:57 ↗
Oliver Munster presented the same laparoscopic technique at IPEG in Beijing.
clinicalTodd Ponsky8:40 ↗
Scars in young children grow proportionally as the child grows.
clinicalTodd Ponsky8:50 ↗
Hiding the scar in the umbilicus offers a cosmetic advantage over midline epigastric scars.
opinionTodd Ponsky8:55 ↗
A supraumbilical or periumbilical incision can reach epigastric hernias located halfway to the xiphoid process, based on experience with pyloric stenosis operations.
clinicalTodd Ponsky9:30 ↗
Some abdominal wall hernias 1-1.5 cm above the umbilicus are full-thickness defects with a peritoneal sac, not true epigastric hernias, and may be misdiagnosed.
clinicalSharif10:20 ↗
Multiple small abdominal wall defects (Swiss cheese pattern) can occur in the epigastric region.
clinicalSharif10:55 ↗
Supraumbilical hernias (1 cm above the umbilicus) can be repaired through a supraumbilical incision hidden in the umbilicus.
clinicalKathy11:01 ↗
Epigastric hernias located midway between xiphoid and umbilicus in children over 1 year are difficult to reach through an umbilical or supraumbilical incision.
clinicalKathy11:30 ↗
What's new+ Show