An umbilical hernia is a weakness that develops in the abdominal wall through and around the belly button, called the umbilicus. A bulge or sac containing fat or intestine pushes out through that weakness, sometimes causing an "outie" belly button.
Most patients with umbilical hernias first notice a belly button bulge or discomfort. Over time these hernias can get larger and more uncomfortable as the hernia sac gets pushed out from inside the abdomen. Like other hernias, an umbilical hernia in an adult will not go away or get better with time without treatment. They can be diagnosed by your doctor or other healthcare provider by listening to your history and performing a good physical examination.
Also like other hernias, umbilical hernias have the risk of becoming stuck. This is called incarceration, and can be dangerous and necessitate emergency surgery. When a hernia becomes incarcerated, you won't be able to flatten the bulge, and you would likely also have very strong pain at the hernia site. This is sometimes accompanied by nausea or vomiting, and the inability to pass gas from the rectum. This is an emergency, and if this happens, you should contact your doctor or go to the Emergency Room for prompt treatment.
Because of the risk of incarceration and symptoms caused by the umbilical hernia, surgical repair is recommended for most patients. At Mount Sinai, surgical repair of small umbilical hernias is usually done using the traditional open surgery method. Larger umbilical hernias are classified as ventral hernias, and can be repaired open or laparoscopically.
Umbilical Hernia Repair
To repair an umbilical hernia, the surgeons at Mount Sinai make an incision within or below the belly button. A surgical mesh, or patch, is usually placed over the site of the hernia to strengthen the weakened area. The mesh is positioned under the skin, within the muscle, and becomes scarred into your tissues. This provides long-term strength to the area to help prevent the hernia from recurring.
An open umbilical hernia repair is usually performed with sedation, to make you relaxed and sleepy, and local anesthesia, to numb the area of the surgery. You are usually able to leave the hospital on the same day of the surgery.
As in any operation, complications such as bleeding, infection, injury to the intestines, blood clots, or heart or lung problems may occur. Before your surgery, your surgeon will recommend testing to determine if it is safe for you to have surgery. A recurrence of the hernia is a late, but rare, complication.
Following Your Surgery
Postoperative recovery depends on the size and difficulty of the hernia repair. Pain is controlled by pain medications prescribed to you on discharge from Mount Sinai. You will be able to walk after the surgery and usually need about three weeks after surgery before restarting heavy physical activity.
Patients usually take about 3-5 days off work after an open umbilical hernia repair.
The Aufses Division of General Surgery
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