Most of the time, umbilical hernias are small and are preferentially treated open, via a limited skin incision. A circular mesh can be easily inserted and placed underneath the muscle without entering into the abdominal cavity (extraperitoneal position).

When the umbilical hernia defect is larger (>3cm in diameter), then a laparoscopic (or keyhole) approach will be favoured, similar to ventral/incisional hernias. In this situation, the hernia content can be safely reduced under direct vision and the defect primarily closed. The repair is further reinforced using a large prosthetic mesh that is introduce (via one of the laparoscopic trocars) into the abdominal cavity, deployed and fixed against the abdominal wall. A generous 5cm mesh overlap of the previously closed hernia defect can be easily achieved, thus significantly reducing the risk of hernia recurrence.