Umbilical hernias are fairly common in adults. They are seen more commonly in overweight people and in women, especially after pregnancy. They tend to get bigger over time. Over time, the fascial layer of the abdominal wall can be worn away under the belly-button, resulting in a hole in the abdominal wall. When a person has an umbilical hernia, abdominal organs, most commonly the small intestine or omentum (a layer of abdominal fat that coats the abdominal cavity), may protrude through this hole and create a visible lump or bulge.
Umbilical hernias may cause discomfort or pain near or around the belly button, when abdominal contents get caught in the hole. Without surgical correction, there is also a risk that some fat or part of the intestine will get stuck (incarcerated) in the hernia and become impossible to push back in. This is usually painful. If the blood supply to this area is cut off (strangulation), urgent surgery is needed.
To avoid these problems, hernia surgery is generally recommended to repair an umbilical hernia. Surgery is also recommended for hernias that are getting larger or are causing more discomfort and pail. Surgery reduces or pushes the abdominal contents back through the hernia or hole into the abdominal cavity. The hole (or tear) is closed with a plastic-like mesh.
Umbilical hernias may either be repaired similarly to an open or traditional inguinal (groin) repair or by laparoscopic surgery. Depending on the size and whether the hernia has been repaired previously will determine which technique is used. Except in instances when the hernia is small or there is an active infection, a piece of mesh will be placed at the time of surgery to reinforce the hernia repair.
In either method (laparoscopic or open), a mesh is placed in order to cover the hernia. The hole is not brought together with stitches but rather, covered by a strong surgical mesh. Thus, the mesh is placed without tension and leads to fewer hernia recurrences. Prior to using the technique of mesh closure, the hernia was closed by sewing the edges of the hole (the hernia) together. This created a great deal of tension and led to many recurrences.
By using mesh to reinforce and support the surrounding tissue, the surgery can effectively repair umbilical hernias. The surgical mesh incorporates itself safely into the abdominal wall. Extending beyond the edges of the original hole or tear, the mesh will not lift or separate later with strenuous physical activity or excessive abdominal straining. The mesh is quite thin and is unable to be felt under the incision.
Umbilical hernia surgery generally takes less than an hour to perform. Most people go home the same day and are back to work within 3 days.
Complications, such as bleeding or infection, are very rare but may occur.
Small umbilical hernias without symptoms may be watched. Surgery may pose greater risks for patients with serious medical problems
