What Is Umbilical Hernia Repair Surgery?
An umbilical hernia is a bulge or pouch that forms in the abdomen. It generally occurs when part of the bowel or fatty tissue inserts into an area near the belly button or pushes through a weakness in the muscle or surrounding abdominal wall. Umbilical hernia repair surgery is a minor and quick operation to push the bulge back into place and to strengthen the abdominal wall and involves an incision at the base of the belly button.
Umbilical hernia repair surgery can be used to treat umbilical hernias in both children and adults. Unlike adults, umbilical hernias in children particularly in babies born prematurely don’t always require surgical repair as they almost always heal without surgery. However, surgery may be recommended if the hernia in children gets large or hasn't disappeared by the time, they reach 3 or 4 years old.
How is Umbilical Hernia Repair Surgery Done?
Umbilical hernia surgery is a fairly quick and simple operation. It generally takes about 20 to 30 minutes. Umbilical hernia surgery is done in two different ways: open hernia repair surgery and laparoscopic (keyhole) hernia repair.
During the conventional open hernia repair, the surgeon makes an incision near your belly button, pushes the pouch back into the abdomen and stitches the cut. In laparoscopic hernia surgery which is a less invasive procedure, the surgeon makes less and smaller incisions around the hernia bulge site, inserts a thin tube with a lighted camera called laparoscope into one of the incisions. This allows the surgeon to view your abdominal cavity on a video screen. Then the surgeon gently pushes the pouch back through the hole in the abdominal wall and stitches the incisions.
Conventional open umbilical hernia repair usually produces an undesirable scar. Laparoscopic surgery repair also requires multiple incisions beyond the umbilicus. Minimal incision scar-less open umbilical repair surgery will be a gold standard in this field, once its effectiveness totally is proven.
To briefly mention the topic of mesh vs. suture repair of umbilical hernia here, both mesh and suture repair is used for the treatment of umbilical hernias; however, there is little evidence whether mesh repair can be advantageous for especially smaller umbilical hernias.
How Do I Prepare for Umbilical Hernia Repair Surgery?
You will likely need to stop taking non-steroidal anti-inflammatory pills such as Aspirin, Ibuprofen, Motrin, Advil or levee several days before the surgery. Not eating for at least six hours before surgery is generally a standard surgical requirement. Your doctor may give you different and personalized instructions before and after the surgery; you need to follow them carefully.
In most cases, the surgery is performed under general anesthesia instead of local anesthesia, which means that you will be asleep and won’t experience any pain during the operation.
Is Umbilical Hernia Repair Surgery Risky?
The risks and complications of umbilical hernia repair surgery are generally very low and rare.
Risks of umbilical hernia surgery and anesthesia in general are:
• Allergic reactions to medicines
• Breathing problems
• Injury to the small or large intestine
• Hernia comes back
• Blood clots
Indications for umbilical hernia repair surgery include pain, incarceration, strangulation, defect larger than 1 cm, skin ulceration, and hernia rupture. Incarceration or strangulation is a particular concern, especially in pregnant patients.
According to a long-term follow-up study conducted in 2017, laparoscopic medium and large umbilical hernia repair have slightly more advantages over open repair concerning early postoperative complications, postoperative pain years later and recurrence.
What are the Symptoms of Umbilical Hernia?
An umbilical hernia creates a swelling or bulge near the belly. If your child has an umbilical hernia, you may notice it only when he or she cries, coughs, laughs or suddenly starts vomiting, because the bulge may disappear when your baby is calm or lies on his or her back. You may seek emergency care if you or your baby have umbilical hernia symptoms such as:
• General discomfort
• Obvious pain
• Tender, swollen or discolored bulge
Recovering from Umbilical Hernia Repair
It's usual to feel sore and uncomfortable just after surgery. Painkillers will help to reduce this feeling. Children will be likely to be sleepy or cry a lot. This is also normal and no need to worry, they will only demand extra attention than adults. Most adults and children are able to return home a few hours after surgery.
There may be bruising and tenderness around the wound during your umbilical hernia recovery time at home. This is normal and generally settles within a week. You can gently resume your daily activities if you can do them without feeling pain. You or your child could take painkillers if your doctor prescribed. Wearing loose clothes in the following days after surgery may help reduce any discomfort. Drinking lots of fluids and eating vegetables, fruit and high-fiber-rich foods can help reduce the possibility of straining on the toilet due to constipation.
This content is edited by Flymedi Medical Editors in April 2019.