After cleaning and disinfecting the surgical site, the patient, lying in supine position, is covered cranially, laterally and caudally. The midline and the planned incision is drawn. Then, the skin incision follows. After the separation of Scarpa's fascia, sharp hooks are placed and upwards traction is applied. Then, preparation is continued to the fascia of the muscles. After that, the navel is circumcised. When dissecting in cranialdirection, one has to take care of the perforators. Hemostasis can be aided by e.g. electric cautery. Now, rectus diastasis is prepared and stutured. After re-positioning the patient with elevated torso, the surplus skin is determined and the tissue to be resected is marked. In the following step, this is symmetrically resected. In the end, the navel has to be re-positioned. Therefore, the skin in the umbilical region is incised in an upside-down U-form and the navel is fitted in with 5 single-button sutures. After placement of a redon-drainage (eg. 10 Redon), the wound can be closed with a 2-layer subcutaneous wound closure, and an abdominal compression bandage can be applied. The navel is patched with ointment gauze, gauze ball and band-aid.
(preparations)
(surgery)
(after surgery 1)
(after surgery 2)