# Successful Repair With Strategic Omentectomy and Meticulous Suturing for Incarcerated Massive Umbilical Hernia in an Adult: A Case Report

## TL;DR

A 65-year-old obese woman with diabetes successfully had a massive umbilical hernia repaired using omentectomy and careful suturing without mesh.

## Contribution

Demonstrates a successful surgical approach for incarcerated umbilical hernias in patients with comorbidities.

## Key findings

- Omentectomy and meticulous suturing led to successful hernia repair in a high-risk patient.
- Postoperative CT scan confirmed no abdominal wall dehiscence.
- Tailored surgical techniques can manage complex umbilical hernias effectively.

## Abstract

This case report details the successful management of a massive incarcerated umbilical hernia in an obese adult patient. Strategic integration of omentectomy and meticulous suturing, excluding mesh repair due to comorbidities of obesity and poorly controlled diabetes, led to an uneventful postoperative course. The 65-year-old female underwent semi-emergency surgery, involving the repositioning of the incarcerated intestinal tract into the abdominal cavity through a substantial omentectomy. Closure of the hernia orifice was performed utilizing alternating absorbable interrupted sutures and non-absorbable far-near/near-far stitches. A myofascial release incision in the bilateral rectus abdominis muscle's anterior sheath further contributed to the procedural success. A postoperative computed tomography (CT) scan confirmed no abdominal wall dehiscence. This case highlights the effectiveness of tailored surgical procedures and provides insights into the management of adult umbilical hernias with complex clinical comorbidities.