Umbilical hernias are one of the most common hernias encountered. They are naturally occurring hernias, common in all ages from infant to elderly. They occur at the navel, also known as they umbilicus. This is the site that the umbilical cord previously passed through and acts as a natural site of weakness in the abdominal wall.
Umbilical hernias present with a painless bulge at the navel, that may become larger and more painful with time. They are usually more symptomatic with activity or prolonged standing.
An umbilical hernia may contain intestine and the intestine may become trapped, also known as strangulated. A strangulated hernia is a surgical emergency that may result in necrotic (dead) intestine and require resection of that portion of the small intestine.
Hernias do not go away spontaneously nor with exercise or homeopathic methods. Physics and gravity usually make hernias increase in size with time.
In most circumstances, nothing more than a physical exam is required to diagnose an umbilical hernia. Occasionally, imaging such as a CT scan may be necessary if there is concern for additional hernias.
The size of the hernia and risk factors for recurrence determine the treatment for your umbilical hernia. Small hernias may be fixed with local anesthetic, sedation and repair of the hernia through an incision less than 1 inch. Sometimes a synthetic mesh is used to repair the hernia, analogous to fixing a flat tire with a patch.
Other hernias may require laparoscopic repair through 3 small 5 millimeter (1/4 inch) incisions. A one size fits all approach to umbilical hernias may not be the best option for you. Each individual is analyzed and a custom surgical approach is chosen based on the patient's risk factors, body type, hernia size and patient's preference.
Umbilical hernia repair is outpatient, same day surgery. Most people take pain medicine for less than 48 hours, if at all. There are no restrictions in walking after surgery. Patients are limited to no lifting > 15 pounds for the first 2 weeks after surgery. Most people are able to return to work within a week with lifting restrictions. Patients may resume light cardio workouts at two weeks and full exercise at four weeks after surgery.
It is often said that no surgeon truly knows his own hernia recurrence rate. How do you know what you are doing is working if you're not keeping track?
The Americas Hernia Society aims to fix just that with the Americas Hernia Society Quality Collaborative or AHSQC. The quality collaborative is a database created by hernia surgeons that enables them to keep track of their performance, patient outcomes and complications. It also allows us to come together to pool our data to add significance and meaning to the numbers.
It is not research and nothing we do is experimental. It is merely a tool to make good surgeons better.
Participating in the AHSQC is completely optional with no obligation. There is no requirement to participate in order to have your hernia repaired.