title: Proposed technique for open repair of a small umbilical hernia and rectus divarication with self-gripping mesh.
abstract: There are a group of patients in which umbilical or epigastric hernias co-exist with rectus divarication. These patients have weak abdominal musculature and are likely to pose a higher risk of recurrence following umbilical hernia repair. We would like to describe a technique for open repair of small (<4 cm) midline hernias in patients with co-existing rectus divarication using self-adhesive synthetic mesh. The use of a self-adhesive mesh avoids the need for suture fixation of the mesh in the superior portion of the abdomen, allowing for a smaller skin incision.
  
  
  
  In 173 patients, preperitoneal self-fixating mesh has been used for the repair of midline hernias <4 cm in diameter. In 58 of these patients, the mesh was extended superiorly to reinforce a concurrent divarication.
  
  
  
  The described technique offers a simple option for open repair of small midline hernias in patients with co-existing rectus divarication, to decrease the risk of upper midline recurrence in an at-risk patient group. This initial case series is able to demonstrate a suitably low rate of recurrence and complications.
authors.affiliation: The Tweed Hospital, Tweed Heads, Australia. ben.j.privett@gmail.com.|School of Medicine, Griffith University, Gold Coast, Australia. ben.j.privett@gmail.com.
authors.forename: B J
authors.initials: BJ
authors.lastname: Privett
authors.affiliation: The Tweed Hospital, Tweed Heads, Australia.|John Flynn Private Hospital, Tugun, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Ghusn
mesh_terms: D006554:Hernia, Umbilical / Q000601:surgery*; D006555:Hernia, Ventral / Q000601:surgery; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D011535:Prune Belly Syndrome / Q000601:surgery*; D017568:Rectus Abdominis / Q000601:surgery; D013526:Surgical Mesh
keywords: Rectus divarication; Self-gripping mesh; Umbilical hernia