Hernias are one of the most common surgical conditions.
Yet it’s the kind of condition many people will live with and worry about whether to seek specialist advice.
If there’s anything you’re unsure about or have questions about, it’s always best to seek specialist medical advice.
The following are frequently asked questions which may be of benefit to you.
WHAT IS AN UMBILICAL HERNIA?
An umbilical hernia is a hernia through or near to the belly button. The umbilicus is the remnant of where the umbilical cord joined you to the placenta during foetal development It was at this point that blood vessels from the placenta entered your body and fed you the nutrition and oxygen from your mother, for growth. Shortly after birth, the small hole at the umbilicus that was present throughout the pregnancy closes off. If the hole fails to close the persistent defect results in a hernia. The hernia is called a neonatal umbilical hernia if it is present from birth. If the hernia presents in an adult it can either be through the umbilicus or adjacent to the umbilicus in which case it is called a paraumbilical hernia.
WHAT ARE THE SYMPTOMS OF AN UMBILICAL HERNIA?
Typically they present with a small swelling in the belly button and sometimes it is almost unnoticeable, just presenting with an asymmetry of the belly button. Pain is an unusual symptom of these hernias, most of which are pain free but they might be slightly sore to the touch or when you lean against something.
DO THESE HERNIAS REQUIRE TREATMENT?
The vast majority of these hernias require no treatment, particularly if there are no symptoms other than a small swelling. If there is pain or the swelling is increasing rapidly, this can be sufficient reason to consider treatment.
IS THERE A RISK OF STRANGULATION IN UMBILICAL HERNIAS?
Strangulation is a very rare complication of umbilical hernias. Most umbilical hernias contain a small amount of intra abdominal fat rather than bowels and so strangulation of this fat is rarely life threatening. If the blood supply to bowels in a hernia becomes compromised (strangulation), this is a potentially life threatening situation which has to be dealt with by emergency surgery.
WHAT ARE THE TREATMENT OPTIONS?
If it is decided that your hernia is best treated, then you will be offered surgery to close the defect in the umbilicus. The most common way to do this is via an incision adjacent to your belly button, usually underneath but sometimes above. The fat or bowel is returned into your abdominal cavity and the hole closed with either stitches or a small cone made of artificial mesh. The skin is usually closed with dissolvable stitches placed under the skin and so are not usually visible.
MY ONE-YEAR-OLD BABY HAS AN UMBILICAL HERNIA, DOES THIS REQUIRE SURGERY?
The majority of neonatal umbilical hernias will spontaneously close by the age of 3 and do not require treatment. If they persist beyond this, you should arrange to see a paediatric surgeon.
CAN THIS SURGERY BE DONE BY ‘KEYHOLE’?
Keyhole surgery requires 3 incisions to place the necessary operating instruments and as the standard approach only requires one small incision, there is no advantage and is not recommended. Also, keyhole surgery requires a general anaesthetic whereas standard surgery can be undertaken under local anaesthetic.
WHAT ARE THE COMPLICATIONS?
Repairing umbilical hernias is very safe and often relatively painless. As with all hernia repairs, there is a risk of wound infection, recurrence of the hernia and possible mesh removal although these are quite rare problems.
WHAT KIND OF RECOVERY CAN I EXPECT FOLLOWING SURGERY?
The surgery is undertaken as a day case and may require painkillers for 3 or 4 days. A waterproof plaster is used to enable you to shower from the day after surgery. Heavy lifting should be avoided for 4 to 6 weeks but otherwise normal activities can be resumed within about a week. It is not necessary to have skin stitches removed as they dissolve over a period of a few weeks and will not be noticed as they are buried under the skin. Walking is encouraged following surgery as this reduces the possibility of developing a clot in the calf (deep vein thrombosis).