Umbilical hernia in infants and toddlers is a fairly common phenomenon, usually resolving on its own by the age of two. In adults, on the other hand, it is a hernia caused by an increase in intra-abdominal pressure - a condition that occurs, for example, during pregnancy, ascites (accumulation of fluid in the abdominal cavity), a heavy cough or obesity.
This is a common finding that is detected in 25-50% of the population by physical examination or ultrasound examination. The finding is 3 times more common in women than in men.
When should an umbilical hernia be operated on?
For an asymptomatic umbilical hernia, no surgery will be needed.
Symptoms of umbilical hernia may include sensitivity to touch. The most significant danger for a hernia is a condition of strangulation in which the contents of the hernia, which is in a narrow and abnormal place, undergo necrosis due to damage to the blood supply.
Surgery for a strangulated hernia is a case of emergency. In the case of a hernia with symptoms or of a large hernia with a risk of strangulation, it is usually recommended to undergo elective (non-emergency) surgery to repair the hernia.
The course of the surgery
Surgery to repair an umbilical hernia can be performed with an open approach or with a laparoscopic approach.
In the open approach the incision is made over the hernia sac or near the navel.
In the case of a large hernia, it is recommended to implement a mesh. The mesh helps to strengthen the abdominal wall, and reduce the recurrence rate of the umbilical hernia down the road.
Laparoscopic access is recommended especially in cases of a hernia larger than 4 cm, with a suspicion of several defects in the abdominal wall which may have led to the hernia, or in patients with complex access to the abdominal wall.
The surgery is performed under general or regional anesthesia.
Preparation before surgery
The surgeon must make an evaluation before the operation, among other things to determine the size of the hernia, its severity and the level of risk involved in the operation and the surgical approach.
In addition, a preliminary evaluation by an anesthesiologist should be performed. Pre existing conditions, regular medications or known allergies should be reported, if any.
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Blood tests will be required which include blood count and biochemistry as well as additional tests depending on the age and medical condition of the patient.
Recovery from surgery
It is usually possible to return home on the day of surgery and in complex medical cases or patients who are unable to eat and drink regularly after surgery there will be a longer hospital stay.
Pain in the surgical area can last up to two weeks. Swelling in the area of surgery may continue for several weeks. It is recommended to take painkillers as needed and avoid wearing clothes that will press on the surgical area. It is also important to maintain a high-fiber diet and drink plenty of water to avoid constipation: Constipation causes an increase in intra-abdominal pressure and can cause pain in the area of surgery.
You can usually return to work within one to two weeks of surgery. Light exercise can help recovery, however it is best to avoid lifting heavy loads for at least 4-6 weeks after surgery.
Success rates from surgery are considered high and with low chances of recurrence of the hernia later on.
Possible complications after surgery to repair the hernia
Complications are relatively rare but largely depend on the size of the hernia and the presence of concomitant diseases. Major complications include bleeding or infection in the area of the surgical wound.
In cases where a mesh has been installed, the chance of contamination of the mesh that will require its re-analysis is very low.
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