A general surgery procedure that repairs a hernia formed when intestine or fatty tissue protrudes through an opening in the abdominal wall at the navel, using sutures or mesh.
Indication
- A palpable or visible bulge at the navel (umbilical hernia)
- Pain or dragging sensation that becomes more apparent with standing, coughing, or straining
- An enlarging hernia at risk of incarceration or strangulation
- Recurrence of a previously repaired hernia
- Symptomatic hernias related to factors increasing intra-abdominal pressure (post-pregnancy, ascites, obesity)
- Cosmetic concerns or restriction of daily life in selected cases
Preparation
- No food or drink for 8 hours before the procedure
- Blood thinners are adjusted with physician approval
- Blood tests, ECG; further investigations if comorbidities are present
- Obesity, chronic cough, constipation, and other factors raising intra-abdominal pressure are reviewed
- Smoking cessation before surgery is recommended for smokers when feasible
How it's performed
- General or regional anesthesia is administered; vital signs are monitored
- In the open approach, a small incision is made around the navel; the hernia sac and contents are evaluated
- The hernia contents are returned to the abdominal cavity; the sac is excised when needed
- Small defects are repaired with sutures alone, while larger or recurrent hernias are repaired using a mesh
- In the laparoscopic approach, the defect is closed with mesh from behind through small incisions
- Skin layers are closed; a compression bandage is applied if needed
Post-procedure
- Discharge is usually on the same or following day
- Mild swelling, bruising, and pain at the wound site may occur during the first weeks
- Heavy lifting and activities raising intra-abdominal pressure are avoided for 4-6 weeks
- An abdominal compression garment may be recommended
- Outpatient follow-up at 7-10 days for wound and suture review
Risks
- Wound infection, hematoma, or seroma
- Persistent numbness or sensitivity
- Rare mesh-related complications (adhesions, infection)
- Recurrence of the hernia — particularly with obesity, smoking, and chronic cough
- Anesthesia reactions, deep vein thrombosis (rare)
FAQ
Do umbilical hernias resolve on their own in babies?
A significant portion of small umbilical hernias in children may close spontaneously by 4-5 years of age. In adults, spontaneous healing is not expected, and surgical repair may be required.
Is surgery essential for umbilical hernia after childbirth?
Observation may be preferred for small, asymptomatic hernias. Surgical repair is planned for hernias that are enlarging, painful, or restricting daily life.
Will mesh be used or just sutures?
The decision depends on the size of the defect, whether the hernia is recurrent, and the patient's characteristics. Mesh is generally preferred for hernias larger than 1.5-2 cm.
When can I return to work?
Return to office work is possible around 1 week; for heavy physical jobs, gradual return is recommended within 3-6 weeks.
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