Hongkong Hernia Centre

Umbilical Hernia

Introduction What symptoms and signs do umbilical hernias cause? Do umbilical hernias need surgery? What are the surgical options?How long does it take to recover after an umbilical hernia repair? References


Introduction top

Umbilical hernia in adults is relatively common and is characterised as being an acquired defect in over 90%.  It is seen mainly in obese women, often after multiple births and in patients with who have an excessive amount of fluid in the abdomen (ascites) which may be associated with liver disease, congestive heart failure and kidney disease.  It is most likely to occur in the fifth and six decades of life.

What symptoms and signs do umbilical hernias cause? top

Often they cause none.  There may be a swelling in the base of the umbilicus which is more noticeable when the patient coughs or strains.  Pain (possibly caused by dragging on the fat and peritoneum of the supporting ligament on the inside of the abdominal cavity in the midline) may also be present.  Localised severe pain, redness, tenderness and general poor well being may indicate strangulation or inflammation.

Do umbilical hernias need surgery? top

No: if the hernias are small and not causing symptoms.   If the hernia is symptomatic then surgery is indicated.

What are the surgical options? top

They can be easily dealt with by open surgery through a small incision, usually below the umbilicus.  If the defect is small then an overlapping sutured repair can be effected but if the defect is any greater than 1cm, it is best repaired using a tension free mesh technique placed in the preperitoneal plane so that the mesh does not stick to the intestines.  A recent study has shown that the mesh repair is superior in terms of reducing the recurrence rate and where the minor complications were similar in both mesh and sutured groups15.

How long does it take to recover after an umbilical hernia repair? top

You can have this repaired as a day case or as an overnight stay.  Recovery is usually about 7 days for most patients.  Your ability to drive a car is governed by being able to put your right foot on the brake pedal to perform an emergency stop without inhibition (automatic transmissions) or both feet on the clutch and brake pedals (manual transmissions).  Avoidance of heavy lifting or straining for three months is recommended to allow the tissues to reach their maximal tensile strength and therefore reduce the risk of recurrence.