Hernia Series Part 2: Ventral and Umbilical Hernias
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In this episode of the Surgical Assistant Podcast, John and Kelly break down ventral, umbilical, and incisional hernias from the surgical first assistant’s point of view, focusing on anatomy, how defects form, and why risk factors like obesity, pregnancy, smoking, diabetes, prior surgery, increased intra-abdominal pressure, and especially wound infection matter for recurrence and outcomes. They review common presentations (pain, bulge), the role of clinical exam and CT imaging, and clarify reducible vs incarcerated vs strangulated hernias and why urgent cases are about freeing compromised bowel. The discussion includes operative considerations such as exposure, protecting bowel, lysis of adhesions, defect measurement, mesh sizing and handling, suture choices, open primary vs open mesh repairs, and robotic positioning tips, plus a practical “vacuum pack/space bag” umbilical dressing technique to help reduce seroma formation.