Fig. 1

Transumbilical double-port laparoscopic surgery combined with extraperitoneal saline injection and high ligation of the hernia sac: A Trocars are inserted on both sides of the umbilical ring; B The diameter of the internal ring is measured under laparoscopy to confirm a giant hernia; C Physiological saline is injected around the internal ring in the extraperitoneal space to float the peritoneal layer; D Purse-string suture of the internal ring is performed in the extraperitoneal space; E The internal ring is closed after purse-string suture; F External appearance of the umbilical incision