The word “hernia” is derived from the Latin word for “rupture”. It is defined as an abnormal protrusion of an organ through a defect in its surrounding walls. It typically occurs due to weakness in the wall.
Umbilical hernia occurs due to a weakness in the abdominal wall in the region of the navel. Umbilical hernias are seen in infants and toddlers as well as in adults.
Umbilical hernias in infants are congenital. They are quite commonly seen and tend to close spontaneously by the age of 2 years. In children, it is rare to see complications because of an umbilical hernia. Umbilical hernia repair surgery is performed if the hernia persists beyond the age of 5 years.
Umbilical hernia in adults is usually acquired. It is more commonly seen in women and in patients with conditions that result in increased intra-abdominal pressure like pregnancy, distension of abdomen due to any cause, ascites etc. Umbilical hernia is also common in obese individuals. Adult umbilical hernia repair surgery can be done by the open method or a laparoscopic umbilical hernia surgery can be performed depending on the patient’s clinical profile.
A protruding swelling through the navel/belly-button is a sign of hernia especially if this swelling, increases in size on straining (coughing, walking etc) and decreases in size on lying down. Sometimes, this swelling may become painful and it may not be possible to push it back into the abdomen. This means that the hernia has become irreducible and one must consult the surgeon immediately. If the swelling has become painful, red, tender and irreducible then it is a sign of strangulation. Strangulated hernia is a surgical emergency and one must visit the hospital without any delay.
Diagnosis of an umbilical hernia is mainly done on clinical examination. An ultrasound of the abdomen may be performed to confirm the size of the defect and determine nature of the contents of the hernia. This helps in deciding the type of umbilical hernia repair surgery.
Nowadays, most often, umbilical hernia repair surgery is performed laparoscopically. As mentioned above most often, umbilical hernia in children does not require surgical treatment. Adult umbilical hernia repair surgery depends on the size of the defect. An open Mayo’s repair or mesh-plasty may be recommended for smaller defects.
Nowadays, laparoscopic umbilical hernia repair surgery is performed more commonly. In laparoscopic umbilical hernia repair surgery, 3 tiny cuts of less than a centimetre are made on the side of the abdomen and the entire surgery is carried out through that. It is recommended to close all defects laparoscopically and then place a mesh from inside in the abdomen.
Laparoscopic umbilical hernia surgery cost depends on a lot of factors. Umbilical hernia repair surgery cost depends on the clinical profile of the patient, type and size of hernia mesh used in surgery, duration of surgery, class of room selected etc. Adult hernia repair surgery cost will also differ based on whether an open or laparoscopic repair is performed. Cost of umbilical hernia repair surgery is higher when performed laparoscopically due to the higher cost of mesh. Cost of adult umbilical hernia repair surgery is usually covered by health insurance.
Unlike in infants, adult umbilical hernias cannot be treated conservatively. There is no medical treatment for hernia. Surgery may be deferred temporarily for reducible hernias but will be needed eventually. The doctor may also decide to defer surgery in patients who are medically unfit to undergo surgery. If the hernia is irreducible or strangulated then an emergency surgery is recommended.
After you have consulted the doctor, you will need to get certain investigations done. Once your investigations have been seen by the doctor and you are medically fit to undergo surgery, a date will be fixed for surgery. If you are on any blood thinner medications, they will need to be stopped atleast 5 days before the surgery. You can get admitted either one evening before or on the morning of surgery based on doctor’s instructions.
Degree of pain is much less after laparoscopic surgery as compared to open surgery. You will be covered with round the clock analgesics during the hospital stay. You will be able to walk around within 4 to 6 hours after surgery.
Most often patients get discharged on the day after their surgery. However, it depends on their clinical profile and condition.
After this surgery, it is advisable to wear an abdominal binder for 3 months. It is also advised not lift any heavy weights and perform any strenuous activities.
You can get back to work within a week after surgery. However, it may vary depending on your clinical condition. Some patients may get back even earlier than a week after surgery and rarely some may take a bit longer.
Rarely a hernia may recur even after surgery. This depends on a lot of factors like the tone of the abdominal wall, size of defect and size of mesh used, activity level of the patient, intra-abdominal fat content etc.
Hernias are very common. Hernia surgery is usually uncomplicated. A strangulated hernia when left untreated can lead to signs and symptoms of obstruction and in later stages can lead to sepsis and become life threatening. Hence it is very important to take timely action in such cases so as to avoid complications at a later stage.