Double half-cone flap umbilicoplasty: A new technique for the proboscoid umbilical hernia in children

Objective: Although many techniques have been described for reconstruction of the protruding umbilicus in children with umbilical hernia, we present a simple new technique for umbilicoplasty. Methods: Ten children (six males and four females) with umbilical hernias and protruding skin were operated upon. Operative description consists of amputation of the protruding umbilical skin, leaving two unequal half-cones, a short cephalic half-cone (0.5 cm) and a long caudal half-cone (1 cm). These two half-cones are fashioned, closed, and inverted to constitute the new umbilicus following a classic hernia repair. Results: The early results were excellent in all cases with no infection and no ischaemic changes encountered in the skin of the reconstructed umbilicus. Follow-up periods between 6 and 18 months revealed a cosmetically pleasing shape of the umbilicus. Only one case developed hypertrophy of the resulting scar. Conclusion: We present our initial experience with the new technique. This new technique provides a good solution for reconstruction of the protruding umbilical skin. Our double half-cone flap umbilicoplasty technique is easy to learn and to perform. © Springer-Verlag 2004.