Umbilical Hernia

An umbilical hernia — also referred to as periumbilical hernia — occurs when the abdominal muscles weaken and form an opening near the belly button, allowing soft tissue or part of the intestines to bulge through it. Umbilical hernias can occur in any population age group, from babies and children to adults. These hernias are common, and most aren’t serious. The hernia may go away without treatment in infants, but adults typically require surgery called hernioplasty to correct it.

Umbilical hernias are common. They account for about 10% of adult abdominal hernias and have been found in 23% to 50% of people during physical examination or ultrasound. Pregnant women are three times more likely to develop an umbilical hernia. Men and women over 60 years old have an equal risk as the muscles in the abdomen get weaker.

Ninety percent of umbilical hernias in adults form because of a combination of weakened abdominal muscles and excessive abdominal pressure. Conditions that place additional pressure on the abdomen, such as pregnancy, raise the risk of an umbilical hernia in adults.

Most umbilical hernias occur in infants. This is because the muscle around the umbilical cord is not yet fully closed. In babies, the hernias usually close up on their own. Infants and young children may also develop umbilical hernias because of congenital malformations of the belly button.

Common symptoms that may appear include a visible bulge near the navel on the abdomen, particularly during coughing fits or when straining, and pain or pressure. However, many umbilical hernias don’t cause symptoms. Some are barely noticeable and are discovered only through an ultrasound. 

Umbilical hernias don’t usually cause pain in babies. They may show as a bulge near the navel, especially when the infant cries, coughs or strains in any way.

Symptoms in adults are typically mild. More intense symptoms may indicate a strangulated hernia, which means tissue becomes trapped within the hernia sac and has its blood supply cut off. Strangulation is a medical emergency requiring surgery to correct.

Doctors use several methods to diagnose an umbilical hernia, including physical exams and imaging techniques such as abdominal X-rays, ultrasounds or CT scans. These tests can determine the hernia size and detect possible complications.

Obtaining an accurate diagnosis is crucial for umbilical hernia treatment planning. After understanding the size and severity of the hernia, your doctor can recommend the appropriate surgery.

Umbilical hernias in babies generally go away without treatment. The closure of the umbilical ring is complete in most children by the age of five, although it can take longer in some cases. Surgery is only recommended if the hernia doesn’t go away on its own by age 5 and if it causes pain, contains a lot of tissue or a complication such as incarceration or strangulation develops.

Managing an umbilical hernia may involve surgical or nonsurgical treatment methods. The best treatment option for an umbilical hernia depends on the size and symptoms. Hernias in adults do not resolve on their own, so patients should consult a doctor if they develop any symptoms to receive appropriate advice and treatment.

Patients with a small and reducible hernia (one where you can push the bulge back in) that causes no discomfort may have the option to wait before getting surgery. In this watchful waiting process, you and your doctor will continue to monitor the hernia for changes.

Untreated umbilical hernias may continue to grow and eventually cause pain and discomfort. Patients who decide to wait should also know that there is a 4% risk of strangulation within five years. It’s important to closely watch the hernia and report any new or worsening symptoms to a doctor.

Hernia Mesh in Umbilical Hernia Repair

Most hernia repair surgeries use hernia mesh made from polypropylene. Polyester or Gore-Tex meshes are seldom used. There are two types of surgical procedures for umbilical hernias, open and laparoscopic. The type of operation you require depends on your age, health, the location of the hernia, its size and whether you’ve had one before.

Open Hernia Repair

In open hernia repair, a surgeon makes an incision near the site, pushes the bulging tissue back into place and then closes the muscle. Small hernias may only need a few sutures to pull the muscle and tissue closed after removing the hernia sac.

Larger hernias require hernioplasty — hernia repair using a mesh — to close the gap. Mesh is a stronger repair option that lowers the risk of having a recurring hernia. The surgeon removes the hernia sac and then uses sutures to attach a mesh patch. The patch extends beyond the hernia opening, taking advantage of the stronger tissue away from the edge to secure the mesh in place.

Laparoscopic Hernia Repair

The second type of hernia repair surgery uses laparoscopic surgery. This procedure is commonly used for hernias over 4 cm in size. The surgeon makes small incisions and inserts hollow tubes to hold a lighted camera and surgical instruments.

After inflating the abdomen with carbon dioxide gas, the surgeon will suture mesh to the muscle tissue surrounding the hernia to strengthen the weak area. Sutures or surgical glue then close the port openings.

Before surgery, your doctor will perform an examination. You may need to have blood tests, a urinalysis or an ultrasound. You will also discuss your medical history, medications and options for pain relief. Don’t eat or drink anything for six hours prior to your operation. Your doctor will advise you if you should take any prescription medications as normal.

The surgery itself is simple and often done as an outpatient procedure with local anesthesia, allowing most patients to go home the same day. However, larger hernias requiring more complex repairs may still require general anesthesia. Plan to have someone available to drive you home. You can then return to your normal activities after a short recovery period. Complex repairs may require general anesthesia and a longer hospital stay.

Open and laparoscopic surgery have similar outcomes, although laparoscopic procedures have a slightly lower risk of wound complications. It’s important to understand potential hernia mesh complications and stay alert for symptoms.

While complications are rare, you must monitor your incision and take note of any symptoms following surgery. Contact your doctor if you develop severe pain, a fever of 101 degrees Fahrenheit or more, chills, stomach cramps, drainage or odor from the incision or if you don’t have a bowel movement for three days.

Mesh failure or chronic pain may occur immediately after surgery or years later. Patients who experienced serious injuries after having a hernia mesh implant can file hernia mesh lawsuits to seek compensation.