Adult Umbilical Hernia Repair
The Condition
An umbilical hernia occurs when a tissue bulges out through an opening in the muscles on the abdomen near the navel or belly button (umbilicus).
Common Symptoms
- Visible bulge on the abdomen, especially when coughing or straining
- Pain or pressure at the hernia site
Treatment Options
Surgical Treatment
The type of operation depends on hernia size and location, and if it is a repeat hernia (recurrence). Your health, age, and the surgeon’s expertise are also important. An operation is the only treatment for a hernia repair.
Your hernia can be repaired either as an open or laparoscopic approach. The repair can be done by using sutures only or adding a piece of mesh.
Open Hernia Repair
The surgeon makes an incision near the hernia site, and the bulging tissue is gently pushed back into the abdomen. Sutures or mesh are used to close the muscle.
- For a suture-only repair: The hernia sac is removed. Then the tissue along the muscle edge is sewn together. The umbilicus is then fixed back to the muscle. This procedure is often used for small defects.6
- For an open mesh repair: The hernia sac is removed. Mesh is placed beneath the hernia site. The mesh is attached using sutures sewn into the stronger tissue surrounding the hernia. The mesh extends 3 to 4 cm beyond the edges of the hernia. The umbilicus is fixed back to the muscle. Mesh is often used for large hernia repairs and reduces the risk that the hernia will come back again.
- For all open repairs, the skin site is closed using sutures, staples, or surgical glue.
- An open repair may be done with local anesthesia and sedation given through an IV.
- Your surgeon may inject a local anesthetic around the hernia repair site to help control pain.
- With complex or large hernias, small drains may be placed going from inside to the outside of the abdomen.
Laparoscopic Hernia Repair
The surgeon will make several small punctures or incisions in the abdomen. Ports or trocars (hollow tubes) are inserted into the openings. Surgical tools and a lighted camera are placed into the ports. The abdomen is inflated with carbon dioxide gas to make it easier for the surgeon to see the hernia. Mesh may be sutured or fixed with staples to the muscle around the hernia site. The port openings are closed with sutures, surgical clips, or glue.
Open hernia repair: An incision is made near the site. Your surgeon will repair the hernia with mesh or by suturing (sewing) the muscle layer closed.
Laparoscopic hernia repair: The hernia is repaired with mesh or sutures inserted through instruments placed into small incisions in the abdomen.
Nonsurgical Procedure: Watchful waiting is generally not recommended for adults with an umbilical hernia. You may be able to wait to repair umbilical hernias that are very small, reducible (can be pushed back in) and not uncomfortable. There is a risk of the intestines being squeezed in the hernia pouch and blood supply being cut off (strangulation). If this happens, you will need an immediate operation.
Expectations
Before your operation: Evaluation may include blood tests, urinalysis, and ultrasound. Your surgeon and anesthesia provider will discuss your health history, home medications, and pain control options.
The day of your operation: You will not eat or drink for six hours before the operation. Most often, you will take your normal medication with a sip of water. You will need someone to drive you home.
Your recovery: For a simple repair, you may go home the same day. You will need to stay longer for complex repairs.
Benefits and Risks of Your Operation
Benefits
An operation is the only way to repair a hernia. You can return to your normal activities and in most cases will not have further discomfort.
Risks of not having an operation
Your hernia may cause pain and increase in size. If your intestine becomes squeezed in the hernia pouch, you will have sudden pain, vomiting, and require an immediate operation.
Possible risks include return of the hernia; infection; injury to the bladder, blood vessels, intestines, or nerves; and continued pain at the hernia site.
The Day of Your Operation
- You should not eat or drink for at least 6 hours before the operation.
- You should bathe or shower and clean your abdomen, especially around the umbilical area, with a mild antibacterial soap.
- You should brush your teeth and rinse your mouth with mouthwash.
- Do not shave the surgical site; the surgical team will clip the hair near the incision site.
What to Bring
- Insurance card and identification
- List of medicines
- Loose-fitting, comfortable clothes
- Slip-on shoes that don’t require that you bend over
- Leave jewelry and valuables at home
After Your Operation
Preventing Pneumonia and Blood Clots
Movement and deep breathing after your operation can help prevent postoperative complications such as blood clots, fluid in your lungs, and pneumonia. Every hour takes 5 to 10 deep breaths and hold each breath for 3 to 5 seconds.
When you have an operation, you are at risk of getting blood clots because of not moving during anesthesia. The longer and more complicated your surgery, the greater the risk. This risk is decreased by getting up and walking 5 to 6 times per day, wearing special support stockings or compression boots on your legs, and, for high-risk patients, taking a medication that thins your blood.
Your Recovery
If general anesthesia is given or if you are taking narcotics for pain, it may cause you to feel different for 2 or 3 days. You may have trouble remembering and feel tired. You should not drive, drink alcohol, or make any big decisions for at least 2 days.
Nutrition
- When you wake up from the anesthesia, you will be able to drink small amounts of liquid. If you do not feel sick, you can begin eating regular foods.
- Continue to drink about 8 to 10 glasses of water each day.
- Eat a high-fiber diet so you don’t strain while having a bowel movement.
Activity
- Slowly increase your activity. Be sure to get up and walk every hour or so to prevent blood clot formation.
Work
- After recovery, you can usually return to work within 3 to 5 days.
- You will not be able to lift anything over 10 pounds, climb, or do strenuous activity for 4 to 6 weeks following surgical repair of an umbilical hernia.
- Lifting limitation may last for 6 months for complex or recurrent repairs.
When to Contact Your Surgeon
Contact your surgeon if you have:
- Pain that will not go away
- Pain that gets worse
- A fever of more than 101°F (38.3°C)
- Repeated vomiting
- Swelling, redness, bleeding, or foul- smelling drainage from your wound site
- Strong or continuous abdominal pain or swelling of your abdomen
- No bowel movement by 3 days after the operation
Call Us
If you have severe pain, stomach cramping, chills or a high fever (over 101°F or 38.3°C), odor or increased drainage from your incision, or no bowel movements for three days.
*We provide procedure education for prospective patients and those who educate them. It is not intended to take the place of a discussion with a qualified surgeon who is familiar with your situation. The American College of Surgeons (ACS) makes every effort to provide information that is accurate and timely, but makes no guarantee in this regard.