What is an umbilical hernia?
An umbilical hernia occurs when there is a defect in the abdominal wall near the belly button, allowing abdominal contents to leave the abdominal cavity. The opening at the abdominal wall at the umbilicus is a natural opening that all of us have. The hole served a purpose, in utero, to get us nutrients from our moms. Some babies are born with umbilical hernias, and most pediatric surgeons will wait a few years as the hole usually gets small enough that it is not visible after the age of 3. Men usually develop an umbilical hernia sometimes through weight gain, or from heavy lifting. Women often develop umbilical hernias as a result of pregnancy. Because the hernia is in the front of the abdomen, gravity rarely push intestine out into the hernia, making these hernias much less dangerous than inguinal hernias.
When should someone get Umbilical Hernia Surgery?
Many patients have little or no symptoms from their umbilical hernia. Some people just notice that they no longer have an "innie" belly button, or someone comments on an "outie" belly button. Some people start having a bit of discomfort when someone, like their kids, bump into their belly button. Discomfort or pain after eating in the belly button is a sign that internal abdominal tissue may have herniated out of the whole, and is an indication for surgery. Sometimes a piece of abdominal fat or intestine can get stuck, also necessitating surgery.
If the hernia becomes symptomatic, treatment is surgical repair.
How does umbilical hernia surgery work?
The two basic ways of repairing an umbilical hernia are with mesh and with sutures.
The most common repair is with mesh. This can be done under local anesthesia using an open technique or under general anesthesia when performed laparoscopically or with the use of a robotic laparoscopic device. In this repair, the contents are pushed back into the abdominal cavity, and a small piece of mesh is placed on the inside of the abdominal wall so that it covers the defect. This mesh is then stitched into place. This is the ideal repair for most patients especially if they are overweight. Recovery time for this procedure is approximately 2 weeks before return to full activity and most people can return to work a day or two after surgery. The mesh repair leads to the least amount of pain and quickest recovery. With the open approach, the mesh is placed between the peritoneum and the abdominal wall, creating a safe barrier between the mesh and abdominal organs. The incidence of mesh related complications or chronic pain after an open mesh umbilical hernia repair is quite rare! In our practice we offer an open preperitoneal, mesh umbilical hernia repair.
Recently, because of new information about mesh, umbilical hernias are often repaired with sutures alone. In this repair, mostly reserved for very small hernias, the defect is stitched closed. The recovery for this procedure is a bit longer than mesh repairs, and likely carries a higher incidence of hernia recurrence. However, we are able to avoid mesh in many thinner patients, especially many women who prefer not to have mesh.
The decision to proceed with umbilical hernia repair with either mesh or sutures is a decision that should be made between you and your surgeon.
Dr. Reinhorn and his team approach:
Our team has been performing umbilical hernia surgery since 2001. We evaluate over 1000 patients with hernia conditions every year and operate on a little less than half of our patients. We specialize in hernia surgery, and we try to tailor our care to each individual. The decision to have surgery or not is very personal, and we feel that having two providers for each patients helps with making a decision. We are happy to evaluate patients for umbilical hernia in our office, located in Newton, Massachusetts, just minutes outside of Boston. Many patients come from Surrounding towns and states to see us.