Umbilicoplasty in Children with Proboscis Umbilical Hernias

In this video, we will demonstrate an umbilical hernia repair for a proboscoid hernia using a V to Y umbiloplasty technique. We can see that this pediatric patient had a significant proboscis associated with their umbilical hernia. We begin with a linear transverse infra umbilical incision. This is extended and taken deeper until the hernia sac is reached. The umbilical stalk is isolated and then divided. Hernia sac is divided and the fascial edges are cleaned. The fascia is then closed with interrupted viral sutures. We now proceed with umbiloplasty and start by marking the V to Y incision. The proboscis is pulled inferiorly to determine where the superior edge will best reapproximate. The excess skin is then excised along the marked lines. As shown here, the vertical portion of the Y is closed with running subcuticular suture to recreate the umbilical stock. We start at the inner edge and sew toward the tip. Once it is reached, the suture is then brought back in to invert the new umbilicus and tack it to the fascia to recreate the umbilicus. The remaining linear infra umbilical incision is then closed with running subcuticular suture. In this video, Vicryl is used for all subcuticular sutures. Dermabond is then applied. The final image demonstrates resolution of the proboscis with recreation of the umbilicus. Thank you for watching.