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Umbilical Hernia

About Umbilical Hernia

An umbilical hernia occurs because of a defect in the muscle of the abdominal wall in the region of the umbilicus (belly button). This is a point of natural weakness where the umbilical cord went through the abdominal wall into the abdomen. This closes off just after birth but in some patients persists and becomes enlarged due to a process of wear and tear.

The typical symptoms of an umbilical hernia are discomfort and swelling in the region of the umbilicus effectively producing an “outy” rather than an “inny”. Some umbilical herniae are reducible i.e. they can be pushed back in when the patient lies down but a significant number are irreducible. Many patients have a small umbilical hernia without realising it and don’t appreciate the fact until this is pointed out to them. Under these circumstances a repair is not really necessary unless they don’t like the appearance. Clearly if the hernia becomes uncomfortable or if there are signs of strangulation then a repair is advisable without undue delay.

The repair involves reducing the hernia contents back into the abdominal cavity and repairing the defect with mesh. This is usually done as an open procedure where by a “smiley” incision is made just below the umbilicus itself. This incision is small and therefore there is no real advantage to attempting to repair an umbilical hernia using laparoscopic (keyhole) surgery. Mesh is used to reinforce the repair in all defects other than those that are only a few millimetres in diameter. It has been shown that use of mesh reduces the risk of a recurrence. The mesh used is made of polypropylene which is totally inert and stays in place forever. The umbilical skin is then anchored to the mesh resulting in an aesthetically pleasing “inny”. The repair is usually performed as a day case under general anaesthesia. Patients are usually well enough to resume normal day to day duties within a few days.

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