Umbilical Hernia Repair Procedure

By:    Published: March 7, 2012

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Umbilical hernia repair is a surgical procedure that is used to mend an umbilical hernia. An umbilical hernia results when a portion of the intestine bulges out from a gap in the abdominal muscles. Umbilical hernias can affect anyone and are fairly common, especially in infants.

What Is An Umbilical Hernia?

An umbilical hernia is a protrusion that can be visually seen or felt around the belly button area. The hernia arises when a segment of the intestine, part of the abdominal lining and/ or abdominal fluid, sticks out through a portion of the abdominal wall muscles.

In infants, this bulge will become very noticeable when the child cries, and will be less protruding when the child is calm. In certain cases, the child may have severe pain and redness at the belly button along with the bulge. Umbilical hernias in infants can occur when the baby is still in utero. While the baby is in the womb, the umbilical cord bypasses a slight gap in the baby’s abdominal muscles. Typically, this gap closes just before birth. However, if it does not close to seam the muscles together, there may be a weak spot that can cause an umbilical hernia to develop at birth or later on in life.

Adults with an umbilical hernia will also see a bulge in the abdomen around the area of the belly button. Occasionally, an umbilical hernia in adults will cause some discomfort in and around the abdomen. Umbilical hernias in adults may be caused in part due to:

  • Heavy Lifting
  • Obesity
  • An Extended Period Of Severe Coughing
  • Numerous Pregnancies
  • Ascites, a build-up of fluid in the abdominal cavity

How Is It Diagnosed?

Generally, an umbilical hernia is diagnosed during a physical examination.  The abdominal bulge caused by an umbilical hernia may range in size from smaller than ½ an inch to about 2 inches in diameter. Additionally, your doctor may request diagnostic tests be performed to rule out other complications. These tests may include:

  • Blood Tests
  • Abdominal Ultrasound
  • X-Ray

What Is The Repair Procedure?

During surgery to repair an umbilical hernia, the patient will be sedated with general anesthesia. If the size of the hernia is relatively small, your surgeon may use an epidural or spinal block that would allow you to remain awake, but free from pain during the procedure. The umbilical hernia repair procedure is as follows:

  • The surgeon will make an incision just below the belly button.
  • Once the hernia is located inside the abdomen, the surgeon will isolate it and untangle it from the surrounding tissue.
  • Next the surgeon will lightly return the intestines to the abdomen.
  • If necessary the surgeon will snip any damaged intestine.
  • The surgeon will then use sturdy stiches to repair the weak abdominal muscle that allowed the hernia to protrude.

Do All Umbilical Hernias Require Surgical Repair?

Not all umbilical hernias require surgical repair. Doctors will often take a “wait-and-see” approach for infants who are born with hernias, as the condition often goes away on its own by around 3 years of age.

Sometimes, doctors will decide to watch hernias carefully in adults rather than remove them surgically if the hernias are small and are not causing any problems. This is especially true for individuals who have serious medical conditions that may be adversely affected by surgery.

In addition to the surgical repair procedure described above, some doctors will elect to repair a hernia with a laparoscopic procedure. This relies on the use of a laparoscope, a tiny tube with a light attached to the end that is inserted through a tiny slit in the abdomen. Other tiny slits are made that are just large enough to insert surgical instruments that are then used to repair the hernia.

When Is Surgical Repair Required For Children

Most infants and young children will not require surgical treatment for a hernia. This is because in the majority of cases, hernias in infants will shrink up and close by the time the infant reaches 3 years of age. There are some circumstances under which children may require surgical repair. Some possible causes for surgical hernia repair in children include:

  • The hernia is causing pain
  • The hernia remains bulged
  • The child’s blood supply is affected by the hernia
  • The hernia is still present when the child reaches 5 years of age

When Is Surgical Repair Required For Adults

Hernias in adults are a fairly common occurrence. This is especially true for individuals who are overweight or obese, and for women who have recently given birth. In these individuals, hernias generally increase in size over time. Doctors will often take a wait-and-see approach for small hernias that are not causing any pain or bothersome symptoms.

If surgery is not performed to repair the hernia, it is possible that a portion of the intestine that has slipped through the hernia may get stuck there. When this painful condition occurs, the hernia cannot be pushed back in and the individual is at an increased risk for developing a strangulation, which occurs when the blood supply is cut off. This is an emergency situation that requires immediate surgical intervention. Symptoms of this condition can include nausea, vomiting and the bulge turning a bluish color.

Because of the seriousness of this condition, many doctors will often recommend that a hernia be repaired surgically soon after diagnosis.

What Are The Risks Of The Procedure

There are very few risks associated with surgical hernia repair other than the basic risks associated with any surgery. Basic risks for any surgical procedure can include:

  • Complications related to anesthesia such as pneumonia or breathing problems
  • Heart problems
  • Infection
  • Bleeding

One possible risk that may be associated with surgical hernia repair can be bowel injury during the procedure, though the incidence of this is extremely low.

What Can I Expect Before The Procedure

A few days prior to the procedure, you are likely to go through pre-surgical testing. This involves providing a complete medical history report as well as a blood test for blood typing and to check for any underlying problems. You will be asked about any medications you are taking and allergies. You will meet with your anesthesiologist and your surgeon to discuss the procedure. They should provide you with detailed instructions for the days leading up to the surgery.

You will be told not to eat or drink anything for the 6 hours prior to your surgery. You may be told to stop taking certain medications, vitamins or supplements for the days leading up to the surgery.

What Can I Expect After The Procedure?

After the procedure, depending on the size of the hernia and how complex the surgery was, you may be able to go home on the same day. Larger hernias of more complicated surgeries may have a longer recovery time and may require that you are admitted for a day or two to the hospital.

Occasionally, even though an outpatient procedure was scheduled, doctors may experience minor complications that can make the surgery more difficult. If this happens, you may wake up from the anesthesia expecting to leave that night only to find that you will have to remain in the hospital for a day or two. This, however, is rare.

Immediately after the procedure is complete, you will remain in the recovery room where your vital signs will be closely monitored by the hospital staff. You will be given pain medication as needed. Once your condition has stabilized, you will either be discharged or admitted to your hospital room.

Upon leaving the hospital, you will be instructed by your doctor on how to care for the incision while you are at home. You may be given a prescription for pain medication, if needed.

Considerations

After the hernia has been repaired and is fully closed, there is a very good chance that it will not recur. However, it is possible that the hernia can recur. The risk of this happening is greater in individuals who have experienced infections in the incision after the surgery. In healthy individuals who did not experience any infection or other complications, the risk of a hernia reoccurring is very low.

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