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.
How are umbilical hernias repaired?
If an umbilical hernia measures less than 1 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 the options include an open mesh repair versus a laparoscopic approach. The laparoscopic, or key hole surgery technique 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.
How long will I be in hospital after surgery?
Most patients will be discharged from the hospital either on the same day of surgery or the morning after surgery with one overnight stay.
How will I feel after the repair?
There is some initial bruising sensation which is well controlled with simple painkillers. This discomfort improves within days of surgery.
Are there any risks to 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.
How long do I need to take off work?
Most people will be back out to work within days or one week of surgery.
When can I resume exercise?
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.