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Umbilical hernia repair


Expert reviewer, Mr Simon Phillips, Consultant Colorectal Surgeon
Next review due July 2020

Umbilical hernia repair is an operation to mend a weak area in your abdominal wall that’s in or near your navel (belly button). This is to stop part of the contents of your abdomen bulging through this weakness (a hernia).

A hernia through the centre of your belly button is called an umbilical hernia. If the weakness is just above or below your belly button, it’s called a paraumbilical hernia. Umbilical hernias are common in babies and young children but they often get better on their own. Adults are more likely to get paraumbilical hernias, which are unlikely to get better without hernia repair surgery.

For convenience, in this factsheet we’ll mostly refer to these two types together as umbilical hernias.


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About umbilical hernia

An umbilical hernia is just one of several different kinds of hernia you may get in your abdomen (tummy). A hernia is due to a weakness somewhere in your abdominal wall. This allows your abdominal lining, some internal fat or even a loop of your bowel to push through the weak area to create a lump. This lump may bulge out when you cough or strain. (The lump from a paraumbilical hernia often appears at the belly button, even though the weakness is actually just above or below).

Umbilical hernias are common in babies but usually go away on their own without the need for any treatment. An operation may be recommended if the hernia is large, or if it’s still there by the time your child reaches four or five.

In adults, umbilical hernias may happen when your abdominal wall is weakened and put under pressure. This may be because of obesity, pregnancy or if you have a medical condition called ascites, when fluid collects inside your abdomen. If you have an umbilical hernia as an adult, there’s a risk that a piece of your bowel could get stuck in the hernia. This is a complication which would need emergency surgical treatment. To avoid this possibility, your surgeon may advise you to have your umbilical hernia surgically repaired.

During an umbilical hernia repair operation your surgeon returns the contents of the hernia back into your abdomen. Your surgeon then repairs the weak area in your abdominal wall.

Preparing for umbilical hernia repair

Your hospital will give you information about how to prepare for your umbilical hernia repair.

If you smoke, they’ll advise you to stop, because smoking increases your risk of getting a chest or wound infection, which can slow your recovery.

An umbilical hernia repair is usually done as a day-case operation. This means you have the operation and go home the same day. However, you may need to stay longer depending on how complex your hernia repair is. Remember to arrange for someone to take you home afterwards as you won’t be able to drive.

The surgery is usually done under general anaesthesia, which means you’ll be asleep during the operation. You’ll be asked not to eat or drink anything for around six hours before your procedure. This is because a general anaesthetic can make you sick. Follow the advice you’re given, and if you have any questions, just ask.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your chance to ask questions so that you understand what will be happening. You don’t have to go ahead with the procedure if you decide you don’t want it. Once you understand the procedure and if you agree to have it, you’ll be asked to sign a consent form.

What are the alternatives to umbilical hernia repair?

In children under 4 years, umbilical hernias often get better on their own and so there may be no need for surgery. Children may need an operation if the hernia doesn’t go away by the time they are four or five, or if the hernia is large.

In adults, the only way to get rid of an umbilical hernia is to have surgery to repair the weakness in your abdominal wall. Once an umbilical hernia has been diagnosed, your doctor may recommend that you have it repaired. This would be to reduce the chance of getting serious complications if a piece of bowel or other tissue gets trapped. Your doctor can discuss with you whether they would recommend a surgical repair in your particular circumstances.

What happens during umbilical hernia repair?

There are two ways of doing an umbilical hernia repair – open and laparoscopic (keyhole). Your surgeon can discuss with you whether an open repair or a keyhole repair would be best in your particular circumstances. They may, for instance, recommend that you have keyhole surgery if your hernia has come back after a previous operation.

We’re giving a general overview here of what you can expect. The exact details about the procedure may be different for you.

Open surgery

Your surgeon will make a small cut just above or below your belly button, and will push the hernia back into place. If the hernia is small, they’ll stitch the weak area in your abdominal wall. For a larger hernia, your surgeon will probably repair the defect with a piece of synthetic mesh. They’ll close the cut, usually with dissolvable stitches, and cover it with a dressing.

Keyhole surgery

Your surgeon will make two to four small cuts in your abdomen, away from the hernia. They’ll then insert a tube-like telescopic camera (laparoscope) which shows the hernia on a monitor. Your surgeon will pass specially designed surgical instruments through the cuts to repair the hernia. Using special staples or stitches, they’ll fix a synthetic mesh to the muscle around the hernia site. They’ll then close the cuts, usually with dissolvable stitches, and cover it with a dressing.

What to expect afterwards

After your umbilical hernia repair, you may feel some discomfort or pain as the anaesthetic wears off. Tell your nurse if you feel you need something to relieve the pain. Some people find they need more pain relief than others.

You’ll usually be able to go home when you feel ready. You’ll need someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours after your umbilical hernia repair.

If your hernia was large or the repair was complicated, you may have a fine drainage tube running out from the wound. You may need to stay in hospital for one to two days until this is removed. Or you may be allowed to go home with the drainage tube still in, and come back to have it removed.

The medicines used for general anaesthesia can stay in your body for a while. Because of this, it’s safest not to drive, drink alcohol, operate machinery or make important decisions for 24 hours after your anaesthetic.

Your nurse will give you some advice about caring for your healing wound(s) before you go home. It’s important to keep the area of your operation dry for one to two days after your operation. You may be given a date for a follow-up appointment.

Dissolvable stitches will usually be absorbed after 10–14 days.

Recovering from umbilical hernia repair

Recovering from umbilical hernia surgery may take a few weeks or a few months, depending on your general health and how complex your surgery was. You’ll need to take it easy in the first few days, and then gradually increase what you do. Your surgeon will give you advice about activities to avoid. For instance, they may advise you to wait for up to six to eight weeks before you do any heavy lifting, perhaps longer.

You should be able to return to work once you feel up to it. Getting back to your normal routine can help you recover. Ask your surgeon what they advise in your circumstances. Everyone responds differently, but you may feel ready for light work about a week after your surgery. This may be longer if your work is strenuous and involves heavy lifting or puts a strain on your abdominal (tummy) muscles. You may find it helpful to talk to your employer about making some adjustments at work while you heal.

You shouldn’t drive until you have recovered well enough to be completely in control of your vehicle. For instance you must be able to perform an emergency stop safely. You may want to contact your motor insurer so that you’re aware of their recommendations, but always follow your surgeon’s advice.

You should ask your surgeon about when you can go back to sporting activities such as weight lifting.

Children should stay off school for a week and then shouldn’t do any strenuous activities for six weeks.

If you need pain relief in the first few days after your umbilical hernia repair, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice. You may also find it helpful to hold a cushion over your abdomen when you cough or move for a while after your surgery. This can act as a splint to ease any discomfort.

It’s important to try to avoid constipation after an umbilical hernia repair, because straining can put pressure on the site of your operation. Eating plenty of fresh fruit and vegetables and drinking plenty of water will help you to avoid getting constipation. A mild laxative may also help you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. After an umbilical hernia repair you’ll have some pain, bruising and minor swelling in your lower abdomen (tummy). This should gradually improve.

If you had laparoscopic (keyhole) surgery you may get some pain in your shoulder. This may happen because of the gas your surgeon put inside your abdomen during the procedure.

See our section on complications below for advice on things to watch out for after your umbilical repair surgery.

Complications

Like all procedures, umbilical hernia repair can sometimes lead to complications. Complications are when problems occur during or after the operation. Your surgeon will be able to let you know how likely these are to happen in your circumstances.

The possible complications of any operation include an unexpected reaction to the anaesthetic or excessive bleeding. Specific complications of an umbilical hernia repair include the following.

  • An infection may start in your wound. This will cause redness, pain, swelling or a discharge from your wound and you’ll need treatment with antibiotics. You’re possibly less likely to get a wound infection if you have keyhole surgery.
  • Your umbilical hernia may come back. This is more likely to happen if you smoke, are overweight or your wound gets infected. If your surgeon has placed some mesh to repair your hernia, the hernia is probably less likely to come back.
  • You may get a collection of fluid, called a seroma, under your wound. This might go away on its own or may need to be drained with a needle.

You should contact the hospital or your GP if you get any of the following after your umbilical hernia repair:

  • pain that doesn’t go away or gets worse
  • a raised temperature
  • repeated vomiting
  • swelling, redness or unpleasant smelling discharge from your wound
  • no bowel movement for three days after your operation

Frequently asked questions

  • Ask your GP to have a look at the hernia. Usually the hernia will go away by itself and no treatment is needed.

    An umbilical hernia is common in babies and young children. It’s caused by a weakness in the tissues in or around the tummy button, which makes the tummy button bulge out. The bulge is usually there from birth. In four out of five children with an umbilical hernia, it goes by the time they are about 5 years old.

    Usually no treatment is necessary. Your GP may refer your child to a surgeon if the hernia is still there by the time your child is 4 or 5. Your child’s surgeon may recommend an operation to repair it. Surgery may also be recommended if the hernia is large (over 1.5cm across) or if it’s painful from time to time.

    Very occasionally, tissues inside your child’s abdomen can become trapped inside the hernia. If this happens, your child’s umbilical hernia may become tender to touch and painful. They may vomit, have tummy pain and be constipated. If this happens, you should seek immediate medical attention – your child may need an operation.

  • Yes, but these should fade gradually.

    There are two main types of hernia repair operation – open and keyhole. Open surgery involves making a small cut just below or above your tummy button. Keyhole surgery involves making two or three small cuts towards the sides of your abdomen.

    The cuts are usually closed with dissolvable stitches, which will be absorbed in about 10–14 days. They will leave small scars which heal completely in around 4 to 6 weeks. The scars will usually continue to soften and fade gradually for up to a year.

  • If you’re pregnant, it’s best to wait until after you’ve given birth to have an umbilical hernia repair.

    If you’re pregnant, the pressure of your growing baby can put stress on a weak area of your abdominal wall near your tummy button. This can cause an umbilical hernia, which is when some of the contents of your abdomen bulge through the weak place to form a lump.

    Doctors usually recommend that adults who have an umbilical hernia should have an operation to get it repaired. This is to prevent tissues from inside your abdomen getting trapped inside the hernia, which can cause serious problems and need urgent surgery.

    Having a hernia shouldn’t affect the delivery of your baby. If you’re pregnant, the usual advice is to wait until after you have your baby to get the repair done. This is because, if you have an umbilical hernia repair, you may need to have a general anaesthetic. This can be potentially harmful to your baby so it’s best not to expose your baby to this risk unless it’s absolutely necessary.

    If you have any concerns or further questions about pregnancy and umbilical hernias, ask your midwife or GP for advice.


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Related information

    • Umbilical hernia. BMJ Best Practice. bestpractice.bmj.com, last updated 22 Jun 2016
    • Abdominal hernias. Medscape. emedicine.medscape.com, updated 21 December 2016
    • Umbilical hernia repair. Medscape. emedicine.medscape.com, updated 19 October 2015
    • Adult umbilical hernia repair. American College of Surgeons. www.facs.org, reviewed April 2016
    • Hernias of the abdominal wall. The MSD Manuals. www.msdmanuals.com, last full review/revision January 2017
    • General surgery. Oxford handbook of operative surgery, 3 ed. (online). Oxford Medicine Online. oxfordmedicine.com, published June 2017
    • Common postoperative complications. PatientPlus. patient.info/patientplus, last checked 27 July 2016
    • Umbilical hernia repair (child). British Association of Paediatric Surgeons. www.baps.org.uk, issued March 2017
    • Personal communication, Mr Simon Phillips, Consultant Colorectal Surgeon, August 2017
    • Returning to work. Royal College of Surgeons. www.rcseng.ac.uk, accessed 18 July 2017
  • Reviewed by Dr Kristina Routh, Freelance Health Editor, Bupa Health Content Team, July 2017
    Expert reviewer, Mr Simon Phillips, Consultant Colorectal Surgeon
    Next review due July 2020



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