The Umbilical Hernia

An umbilical hernia, while generally benign, can be a serious condition. It can often result in severe abdominal pain, requiring immediate medical attention.

This type of hernia is not a genetic condition; however there is a tendency for it to occur within families. Most adults who develop an umbilical hernia tend to be overweight, pregnant women, or have generally weak abdominal muscles. Exercises, lifting heavy objects, severe coughing/sneezing episodes are some of the most common causes of this malady. Additionally, persons with certain liver diseases are prone to develop an umbilical hernia.

Treatment options for an umbilical hernia vary depending on the person. Most repairs are done to relieve pain and discomfort associated with the condition; however, this may not be the best course of action in all cases. If a persons daily activities involve an inordinate amount of use of the abdomen (lifting, moving heavy objects, or the like), then it may be necessary to repair the hernia. Failure to repair the hernia in such persons can cause the abdominal lining or intestines to push through the hole in the muscle. This complication causes the tissue to become strangulated or incarcerated.

Strangulation is a condition where circulation of blood, oxygen and nutrients is cut off from the affected tissue. Strangulation or incarceration of abdominal tissue can cause a multitude of issues for the patient, including, but not limited to: nausea, vomiting, abdominal swelling or distension, pale complexion, weakness or dizziness, and/or extreme pain. If the strangulation or incarceration continues for too long, the tissue will die and become infected.

The only option for umbilical hernia repair is surgery, in a procedure called herniorraphy. This can be done either with laparoscopic or open surgical techniques. The procedure is almost always done on a same day basis, with the patient able to go home after a few hours. Most hernia repairs take about two hours to perform.

The procedure involves the patient being administered an anesthetic (local, spinal or general). The surgeon then will make a small incision in the umbilical area (the belly button). The herniated tissue is then pushed back into the abdominal cavity or cut out. After this, the surgeon will either use a surgical mesh to cover the hole in the muscle wall or use sutures to tie the hole closed. This depends on the patient and the size of the hernia. The surgeon will then close the incision(s) he made with steri-strips or stitches.

After the patient has recuperated sufficiently, he or she will be discharged from the hospital with after care instructions for care of the incision site(s). The specific instructions will depend on the type of surgery performed (open or laparoscopic). Typically, it will involve a mild pain medicine, instructions on how to care for the incisions and bandage dressing.

Since an umbilical hernia is usually considered an elective surgery, there are a few questions one must ask a surgeon before deciding to have the surgery. These questions include: How soon can my I return to normal activities? How soon can I return to work? When can I drive? What should I do to take care of the incision? How many times have you performed this surgery? What kinds of complications are there to this procedure? What kinds of complications have your patients experienced?

While serious complications after surgery are rare, they can occur. Usually serious complication occur due to an inexperienced surgeon or because the patient did not fully understand the procedure or the after care instructions. Before going ahead and having the procedure, make sure you are comfortable with the answers the surgeon gives you, as well as your overall feeling towards him or her.