By the term umbilical hernia we mean the projection of abdominal contents (intestine or omentum) through a gap (hole) in the abdominal wall in the area of the umbilicus. A hernia located up to 3cm above or below the umbilicus is called an umbilical hernia. It is most commonly found in infants and young children, but it also occurs in adults where it is the second most common form of hernia after the inguinal hernia. It accounts for 6-14% of all abdominal wall hernias and occurs more commonly in women.
CAUSES OF UMBILICAL HERNIA
Intense weight lifting
In the majority of cases, a clinical examination by a General Surgeon is sufficient to establish the diagnosis of umbilical hernia. In case there is doubt or we want to accurately determine the size of the hernia, we proceed with an ultrasound scan of the area, while in some cases we perform a CT scan of the area.
Symptoms of umbilical hernia vary. Many times it is asymptomatic and the patient notices a mass (lump) in the area of the umbilicus which goes in and out frequently. Often the umbilical hernia begins to cause pain in the area and becomes tender to palpation. In more advanced stages, the contents of the hernia may be strangulated and the patient may experience vomiting and inhibition of stool and gas. The latter is a particularly dangerous situation that requires immediate surgical intervention as the patient’s life is at risk.
There is no conservative treatment for umbilical hernia. The only treatment is surgical repair. Special bands used to prevent hernia prolapse are of no use as they neither protect nor at the same time make subsequent surgery difficult by causing adhesions in the area. Once the diagnosis of umbilical hernia is established, the indicated treatment is planned surgical repair. Delaying surgery can cause the hernia to swell and have higher rates of recurrence when it is surgically repaired.
At the same time, if the umbilical hernia turns into strangulated, then the surgery becomes more dangerous for the patient and the recurrence rates are higher. The operation to repair the umbilical hernia is done in two ways:
– With an incision in the area of the umbilical hernia and retraction of the hernia. The gap (hole) in case it is smaller than 2 cm can simply be sewn up with special techniques, while in case it is larger, mesh placement is required to restore the hernia. Depending on the size of the hernia and the preference of the surgeon, the mesh can be placed intraperitoneally, preperitoneally or extraperitoneally.
– Gold standard operation is laparoscopic repair. In all specialized centers abroad, the laparoscopic treatment of umbilical hernia has been established and has replaced the classic open approach. Through three small holes with a diameter of 0.3-1 cm, the operation is carried out, where the hernia is first repositioned and then a special dual mesh is placed to strengthen the abdominal wall and prevent recurrence. The operation is painless, bloodless and the patient leaves the clinic the same or the next day.
ADVANTAGES OF LAPAROSCOPIC TREATMENT
Significantly less postoperative pain
Faster recovery and immediate return to work and daily activities
Better cosmetic result as large incisions are avoided
Lower recurrence rates compared to the open method according to international literature
I have a pain in the umbilicus area. Do I have an umbilical hernia for sure?
Not necessarily. There are other conditions that cause pain in the area (umbilitis, musculoskeletal pain).
What doctor should I visit if I suspect I have an umbilical hernia?
The appropriate physician is the Surgeon General
I have an umbilical hernia but it doesn’t cause me any particular symptoms. Should I have surgery?
Once the diagnosis of umbilical hernia is made, the correct treatment is surgical repair to avoid complications. At the same time, the longer we delay the operation, the larger the size of the umbilical hernia grows and the more difficult the surgery becomes, while the chances of future recurrence also increase.
I have an umbilical hernia. Is it better to have open or laparoscopic repair?
In case of a very small umbilical hernia then the open approach is also a good option. However, if the hernia is larger then the laparoscopic approach is significantly advantageous and is the appropriate choice.
How long do I have to be off work if I have surgery?
In the case of laparoscopic reconstruction, if our work does not require weight lifting, the return is a matter of a few days. If heavy lifting is required then we should refrain for at least 30 days to avoid the risk of recurrence.
How much does umbilical hernia surgery cost?
Many factors contribute to the final cost. The patients insurance as well as the type of mesh to be used play an important role. Laparoscopic repair is clearly more expensive than the open technique.
How long does it take to schedule an umbilical hernia surgery?
The booking is immediate and the operation can be done even the day after the clinical examination.
What kind of anesthesia do I need for the operation?
In the case of a small umbilical hernia, this can be performed even with local anesthesia. In a larger hernia, general anesthesia is necessary.