Redo pull-through procedures are not without their complications and have results that are satisfactory only in 70 % to 80 % of cases. Persistent obstructive symptoms due to anastomotic stricture are a common indication for redo operation in 30 % to 50 % of cases. Management of stricture following a redo operation can still be a complicated issue with limited available options. One such case is presented and management discussed.

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Context: An aesthetically acceptable umbilicus is an important component of the body and absent or dysmorphia may lead to psychological discomfort. Therefore reconstruction of neoumbilicus attains importance in abdominal surgical planning. This innovative surgical creation of umbilicus was planned during the initial surgery of umbilical defects to achieve these goals with minimal scarring. Materials and Methods: Our technique was applied to all 26 cases: primary omphalocele repair ( n = 5), abdominal wall reconstructions after conservative management of large omphaloceles ( n = 17), large umbilical hernias ( n = 3), and one case of patent vitelointestinal duct with redundant skin. All patients were followed up yearly for the aesthetic appearance and clinical photographs were recorded. Results: Technique applied to all 26 patients had excellent cosmesis and long term follow up was very encouraging. Conclusions: All patients had successful abdominal wall closure. Most of the patients had minimal scar of the large hernia repair and the umbilicus was normal looking and well accepted cosmetically.