Umbilical hernia repair

Expert reviewer, Mr Christian Macutkiewicz, Consultant General and Hepato-Pancreatico-Biliary Surgeon
Next review due October 2022

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

An older lady in the pool

About umbilical hernia repair

If you have a hernia, your abdominal lining, some fat or even a loop of your bowel may push through the weak area in your abdominal wall to create a lump.

Umbilical hernias are common in babies but usually go away on their own without the need for any treatment. 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, which is called a strangulated hernia. This can be dangerous and would need emergency surgical treatment. To avoid this, your surgeon may advise you to have umbilical hernia repair.

During an umbilical hernia repair operation your surgeon will return the contents of the hernia back into your abdomen. They’ll then repair the weak area in your abdominal wall.

Preparation for umbilical hernia repair

Your surgeon will explain how to prepare for your umbilical hernia repair. For example, 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, which means you have the operation and go home the same day. But you might need to stay longer depending on how complex your hernia repair is. You’ll need 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. A general anaesthetic can make you sick so it’s important that you don’t eat or drink anything for around six hours before your procedure. You can usually drink water up to two hours before, but check with your anaesthetist or surgeon and always follow their advice.

Your nurse or surgeon will discuss with you what will happen before, during and after your procedure, including any pain you might have. If you’re unsure about anything, ask. No question is too small. Being fully informed will help you feel more at ease and will allow you to give your consent for the procedure to go ahead. You may be asked to do this by signing a consent form.

Umbilical hernia repair

There are two ways of doing an umbilical hernia repair – open and keyhole (laparoscopic). Your surgeon will tell you which will be the best option for you. An open umbilical hernia repair usually takes about half an hour to 45 minutes and keyhole surgery takes about an hour.

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 area 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 called a laparoscope, which shows the hernia on a monitor. Your surgeon will pass surgical instruments through the cuts to repair the hernia. And they may pass carbon dioxide gas into your tummy to inflate it to help them see your hernia. Next, your surgeon will fix a synthetic mesh to the muscle around the hernia site using staples or stitches. They’ll close the cuts, usually with dissolvable stitches, and cover it with a dressing.

Aftercare for umbilical hernia repair

After your umbilical hernia repair, you may feel some discomfort or pain as the anaesthetic wears off. Tell your nurse if you need some pain relief.

You’ll usually be able to go home the same day you have the operation, as soon as you feel ready.

If your hernia was large or the repair was complicated, your surgeon may have to run a fine drainage tube out from the wound. You may need to stay in hospital until they can remove it. Ask your surgeon for more information if you have a drainage tube.

The medicines used for general anaesthesia can stay in your body for a while. Because of this, it’s best 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 before you go home. It’s important to keep the area of your operation dry for two days after your operation. You may be given a date for a follow-up appointment.

Dissolvable stitches will usually take about 10 to 14 days to disappear.

Recovering from umbilical hernia repair

The recovery time from umbilical hernia surgery may be anything from a few weeks to a few months, depending on your general health and how complex your surgery was. 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 find it helpful to hold a cushion over your tummy 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. Eat plenty of fresh fruit and vegetables and drink plenty of water to help avoid this. You could also take a mild laxative.

You’ll need to take it easy in the first few days, and then gradually increase what you do. You may be able to get back to your normal activities after a week or two as long as they don’t cause you any pain. You should be able to go for walks, or a gentle jog, a light bike ride or exercise in the first two weeks but check with your surgeon. Stretching, bending down and using your abdominal muscles may feel uncomfortable during this time but will settle down.

Your surgeon will give you advice about activities to avoid. For instance, they may advise you to wait for up to six weeks before you do any strenuous exercise, weightlifting, hard cycling and strenuous swimming. You should also wait six weeks before you have sex to allow yourself time to recover from your operation. If you had a larger umbilical hernia repair, you might need to wait up to eight weeks to do these activities.

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 for your circumstances. Everyone responds differently, but you may feel ready for light work a few days after your surgery. It may take you longer to return if your work is strenuous and involves heavy lifting or puts a strain on your tummy muscles. Children should stay off school for a week and then shouldn’t do any strenuous activities for six weeks.

You shouldn’t drive until you have recovered well enough to be completely in control of your vehicle. Ask your surgeon for their advice on when you can drive again. The Driver and Vehicle Licensing Agency (DVLA) may also be able to give you some advice.

Side-effects of umbilical hernia repair

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, discomfort and bruising in your tummy. This should gradually improve and get better after a couple of weeks. You may also feel some tightness in your abdominal muscles like you’ve done sit-ups. This is completely normal and will usually settle down after a couple of weeks. There may also be some numbness around your belly button, which will take a while to recover but in some larger hernias, can be permanent.

If you had keyhole surgery, you may get pain in your shoulder because of the carbon dioxide gas your surgeon put inside your tummy during the procedure. It may help to get up and walk around a bit to ease this.

Complications of umbilical hernia repair

Complications are when problems occur during or after the operation. Your surgeon will let you know how likely these are to happen.

Complications of an umbilical hernia repair include the following.

  • Your wound may get infected. If the wound is red, painful and swollen and has a discharge coming from it, you’ll need treatment with antibiotics. You’re possibly less likely to get a wound infection if you have keyhole surgery.
  • Your wound may bleed after the operation.
  • Your umbilical hernia may come back, which is called a recurrent hernia. 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. If it does come back, you’ll probably need to have another operation (recurrent umbilical hernia repair), usually with keyhole surgery.
  • 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.

Contact your hospital or GP if you:

  • have pain that doesn’t go away or gets worse
  • have stomach cramps
  • have a raised temperature or chills
  • keep vomiting
  • have a smelly discharge coming from your wound, or it looks red and swollen
  • haven’t been to the toilet to poo for three days after your operation

Alternatives to umbilical hernia repair

In children under five, umbilical hernias often get better on their own and so they might not need surgery. Children may need an operation if the hernia doesn’t go away by this time, or if their hernia is large. See our FAQ below for more information: What should I do if my baby has an umbilical hernia?

In adults, the only way to get rid of an umbilical hernia is to have surgery to repair the weakness in your abdominal wall. However, your doctor may suggest waiting for a while to see how you get on before having surgery. Your doctor will discuss whether they would recommend a surgical repair for you. They may suggest a repair to reduce the chance of getting serious complications if a piece of bowel or other tissue gets trapped.

Frequently asked questions

  • Ask your GP to have a look at the hernia. Usually it will go away by itself and your baby won’t need any treatment. Your GP may refer your child to see a surgeon if they still have an umbilical hernia when they reach four or five. Your child’s surgeon may recommend an operation to repair it. Surgery may also be a good option if the hernia is large (over 1.5cm across) or if it’s painful.

    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 immediately.

  • Yes, you’ll have small scars that will heal in around four to six weeks. The scars will usually continue to soften and fade gradually for up to a year.

    If you had open surgery, the size of your scar will depend on the size of the hernia you had repaired. If you had keyhole surgery, most scars are five to 10mm.

  • 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.

    It’s best to wait until after you’ve given birth to treat an umbilical hernia because 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.

    Having a hernia shouldn’t affect the delivery of your baby and after you have given birth, the umbilical hernia will usually get smaller. You will only need to have an operation if the hernia is strangulated (when a piece of your bowel gets stuck in the hernia).

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  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, October 2019
    Expert reviewer, Mr Christian Macutkiewicz, Consultant General and Hepato-Pancreatico-Biliary Surgeon
    Next review due October 2022