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Repair umbilical hernia, age 5 years or older; incarcerated or strangulated

CPT4 code

Name of the Procedure:

Repair umbilical hernia, age 5 years or older; incarcerated or strangulated.
Common names: Umbilical hernia repair, incarcerated umbilical hernia surgery, strangulated umbilical hernia repair.

Summary

An umbilical hernia repair is a surgical procedure to fix a hernia located near the navel (belly button) that is stuck (incarcerated) or has its blood supply cut off (strangulated). This involves returning the herniated tissue back into place and repairing the abdominal wall.

Purpose

  • Addresses the issue of an umbilical hernia that is stuck or has lost its blood supply.
  • Aims to prevent complications such as tissue death, infection, and severe pain.
  • Expected outcomes include relief from symptoms and prevention of further hernia complications.

Indications

  • Symptoms include severe pain, swelling, redness, or discoloration near the navel.
  • Appropriate for patients aged 5 years or older with an incarcerated or strangulated umbilical hernia.
  • Other factors may include failure of the hernia to reduce manually or signs of infection.

Preparation

  • Patient may need to fast for several hours before the procedure.
  • Adjustments in medications, especially blood thinners, may be required.
  • Diagnostic tests such as ultrasound or CT scans are often performed to assess the hernia.

Procedure Description

  1. The patient is placed under general anesthesia to ensure they are asleep and pain-free.
  2. An incision is made near the navel to access the hernia.
  3. The herniated tissue is carefully pushed back into the abdomen.
  4. The abdominal wall defect is repaired using sutures, and sometimes a mesh is placed for added support.
  5. The incision is closed with stitches or surgical glue.

Duration

The procedure typically takes about 30 to 60 minutes, depending on the complexity.

Setting

Performed in a hospital operating room or surgical center.

Personnel

  • Surgeon
  • Anesthesiologist
  • Surgical nurse
  • Possible assisting surgical staff

Risks and Complications

Common risks:

  • Infection
  • Bleeding
  • Pain at the incision site

Rare risks:

  • Recurrence of the hernia
  • Injury to surrounding organs or tissues
  • Anesthesia-related complications

Benefits

  • Relief from pain and discomfort.
  • Reduced risk of complications associated with incarcerated or strangulated hernias.
  • Improved quality of life.
  • Benefits can be realized immediately after recovery.

Recovery

  • Post-procedure care includes managing pain with medications and keeping the incision site clean and dry.
  • Most patients can walk short distances the same day but should avoid heavy lifting for several weeks.
  • Follow-up appointments are necessary to monitor healing.

Alternatives

  • Watchful waiting for non-incarcerated hernias (not recommended for incarcerated or strangulated cases).
  • Non-surgical methods are generally ineffective for incarcerated or strangulated hernias.
  • Each alternative has its pros and cons, but surgical repair is typically the best option for the indicated condition.

Patient Experience

  • During the procedure, the patient is under general anesthesia and will not feel pain.
  • Post-procedure, there may be discomfort and soreness around the incision, managed with pain medications.
  • Most patients can return to normal activities within a few weeks, following doctor's advice and restrictions.

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