A new concept of the aetiology and surgical repair of paraumbilical and epigastric hernias.

The aetiological factors concerned in the production of paraumbilical and epigastric hernias have been reviewed along structural--functional lines. A positive relation between the aponeurotic pattern and herniation was demonstrable at operation in 25 patients with paraumbilical or epigastric hernias. The effect of abdominal distension, obesity, and straining are discussed. A new type of surgical repair planned on this basis is described. The preliminary results obtained with this technique are reported, with a discussion of other previously described types of surgery.