Epigastric hernias are usually protrusions of properitoneal
fat, but occasionally contain omentum. They appear through
a defect in the linea alba and are normally found in the
midline between the xiphisternum and the umbilicus. There
is no peritoneal sac.
the hernia is single, make a transverse incision over
the swelling. Make a midline incision over multiple midline
the herniated fatty mass down to its neck, make an opening
in the neck, and excise both the covering and the extra
peritoneal fat. Define the fibrous margins of the defect
and close it with interrupted non-absorbable suture as
described for para-umbilical hernia.