Umbilical hernia


The navel is a congenitally sensitive point, through which all the blood vessels of the umbilical cord pass. An umbilical hernia, one of the most common problems in the anterior abdominal wall, may appear when part of the intestine bulges out through an opening in the abdominal muscles close to the navel, causing swelling and increased pressure in the abdomen.
Umbilical hernias can be congenital (fetal umbilical hernia) or is acquired (umbilical hernia in children). It is generally a common type of hernia in newborns but also in women of reproductive age, after childbirth (umbilical hernia after pregnancy).

What are the typical symptoms of an umbilical hernia?

The most common symptoms of an umbilical hernia include a lump in the navel, as well as abdominal discomfort and pain, which can be mild or more severe depending on the intra-abdominal pressure.
In general, an umbilical hernia can be gently pushed or massaged back into its proper place within the abdomen and very rarely it is swollen.
In the case of a problem or complication, the pain may be recurrent or constant meaning it is urgent for the patient to receive surgical treatment before the hernia gets strangulated. There are also cases where there can be pain, without any apparent swelling.

Umbilical hernia strangulation

Hernia strangulation is a serious complication, which presents all the above symptoms along with a redness of the area. Blood supply to the viscera that has caused the strangulation is compromised and may lead to its necrosis. This is an emergency situation that requires umbilical hernia surgery.

Diagnosis of an umbilical hernia

The diagnosis is made by the surgeon based on the patient’s symptoms and medical history. If the result of an initial clinical examination is poor, ultrasound and magnetic resonance imaging may be necessary.

Umbilical hernia treatment: Meshes, laparoscopy or both?

Umbilical hernia can only be treated with surgery. The application of meshes constitutes a revolution in hernia surgery, as they minimize pain and complications. They are entirely biocompatible with the human body and there is standard use of them in umbilical hernia surgery.
Laparoscopic surgery constitutes the second major revolution in the treatment of umbilical hernia. Therefore, the advantages of meshes can be combined with all the positive features of laparoscopy.
The decision for the type of surgery (open or laparoscopic) necessary for the treatment of abdominal wall hernias, should be made by a specialized general surgeon based on the profile of each patient and always bearing in mind which method is more effective, minimizes possible complications and offers a better recovery.

How easy is recovery after surgery?

Open surgery for umbilical hernia may have an advantage in terms of cost, but it is rarely the choice of the surgeon because it has disadvantages in terms of recovery time and cosmetic result.
Laparoscopy is usually preferred with obese patients, in cases of hernia recurrence or when dealing with severe cases. After laparoscopic treatment, the patient recovers much faster and is mobilized immediately. The next day the patients receives a mild antibiotic treatment and may return to work in a short time.
In case of small hernias, a new sophisticated technique applied in recent years and involving the use of novel types of meshes, can be used. Often, general anesthesia is not required. This is very important factor for patients with cardiovascular problems who require hernia surgery. Cardiovascular patients also can go home the same day.

Are there complications?

Complications after umbilical hernia surgery are quite rare. In general, one must follow the doctor’s instructions closely. Specifically:
• If you notice redness around the belly button, contact your surgeon immediately.
• Avoid constipation by following a proper diet.
• After surgery, avoid lifting weights of more than 5 kg for a short period of time.