- What is an umbilical hernia?
- Do umbilical hernias need to be repaired?
- How are umbilical hernias repaired?
- How long will I be in hospital?
- How will I feel after the repair?
- Are there any risks to surgery?
- How long do I need to take off work?
- When can I resume exercise?
An umbilical hernia is a weakness in the muscles and ligaments around the umbilical area. These hernias can be present at birth or more commonly will develop during adult life. Any condition that increases the pressure within the abdomen can contribute to the development of an umbilical hernia. Therefore these hernias are more common after pregnancy, in people who have central abdominal obesity, in weight lifters or those whose job involves heavy lifting and people with a chronic cough or constipation. In addition to this there may be a natural family predisposition to a hernia in this area.
If a hernia is small and measures 1 cm diameter or less and the hernia is not causing symptoms then they do not need to be repaired. However invariably these hernias will get bigger in time and may then become painful. The decision on whether to operate or not should be taken after discussion in the outpatients’ clinic on the advantages and risks of surgery versus those of not operating.
If an umbilical hernia measures less than 2 cm diameter at its base then I would repair them using a very simple and safe open technique, whereby a small cut is made in the upper crease of the umbilicus. The hernia is pushed back inside the abdomen and the weakness is repaired with simple suturing. If the hernia is larger than 2cm then I would recommend a laparoscopic, or key hole surgery technique to repair it. This involves 3 small cuts measuring 5 to 10mm in the left side of the abdomen. The hernia is reinforced with a lightweight mesh which is secured on the inside underneath the hernia. The mesh encourages scar tissue to form and therefore strengthens the whole area, decreasing the chance of a recurrence of the hernia.
Most patients will be discharged from the hospital either on the same day of surgery or the morning after surgery with one overnight stay.
There is some initial bruising sensation which is well controlled with simple painkillers. This discomfort improves within days of surgery.
This procedure has a very low risk. There may be a small chance of bruising or a low grade infection in the wound following an open operation. With a laparoscopic procedure there are very low risks of bleeding, damage to the bowel or adhesion formation. The risk of recurrence of the hernia after operation is low but the chance of recurrence would be increased in patients who have increased intra-abdominal pressures, such as those with central obesity or after further pregnancy.
Most people will be back out to work within days or one week of surgery.
Aerobic exercise such as running, cycling and swimming can be resumed within days of surgery. I would advise that patients refrain from heavy lifting of weights or suitcase etc. for six weeks after surgery to decrease the chance of the hernia recurring.