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Umbilical hernia repair

Before you agree to have your umbilical hernia operation it is important to know all you can about it. The information here is a guide to umbilical hernia symptoms and treatment, and is based on common medical practice. Each hospital and doctor will have slightly different ways of doing things when dealing with an umbilical hernia repair, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when you and your doctors are choosing a form of umbilical hernia treatment. You should mention any worries you have. Remember that you can ask for more information at any time.

 

 

What is the problem?

You have a swelling or pain in the tummy button, called your umbilicus. This is due to a rupture, known as a hernia. Because of its position in the tummy button, the rupture is called an umbilical hernia.

 

What is a hernia?

A hernia is a pouch that pushes through a muscle sheet, such as the tummy wall. Before birth, there is always a gap and a hernia in the tummy button, where the umbilical cord is attached to the unborn child. This usually disappears before birth, but there is often a weakness there throughout life.

 

What has gone wrong?

The hernia pouch or sac is the lining of the inside of the tummy wall. It pushes through the weakness at the tummy button. The sac has a fatty covering and inside there may be bowel or fatty tissue called omentum. The sac steadily gets larger and can be painful. The bowel and omentum may get stuck in the sac. Their blood supply can be cut off and the bowel and omentum can strangulate and die. This causes vomiting, great pain and is very serious

Umbilical hernia repair

Sometimes a hernia appears as the nearby body wall weakens with the passing of time.

 

Sometimes the hernia is caused when coughing, heavy work or sport overstrains the tissues.

 

Umbilical hernias are very common and easily treated, particularly when small. If treated when they are small, this will prevent strangulation and make the strongest repair.

 

The aims

The aims are threefold.

 

  • To remove any bowel or omentum from the hernia. This usually means pushing them back inside the tummy cavity. If the bowel or omentum is strangulated, they may need to be removed.

 

  • To remove or push back the sac.
  • To repair the weakness to prevent the hernia coming back.

 

The most common way to do the operation is while you are asleep with a general anaesthetic. A local anaesthetic may be used for a very small hernia.

 

The benefits

You should stop having pain and the swelling will be gone. There should be no risk of strangulation.

 

Are there any alternatives?

Simply waiting and seeing if you have more trouble, is reasonable if the hernia is not giving any pain.

 

The repair of a very large hernia can be a major operation. A balance is needed between the risks of the operation and the risks of the hernia strangulating. An abdominal support may be worthwhile if an operation may be dangerous.

 

Some very large hernias have several loops of bowel in them. If one loop strangulates, it may be safer to limit the operation to the removal of the damaged bowel and to not add the risks of a hernia repair at that time.

 

Author: Mr Michael Edwards FRCSEng FRCSEd. Consultant general surgeon.

© Dumas Ltd 2006

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