Umbilical hernia repair

Umbilical hernia repair is an operation to mend a weak area or hole in your tummy wall that’s in or near your belly button. The surgery stops part of your tummy contents from bulging through the wall. This bulge is called a hernia.

About umbilical hernia repair

If you have a hernia, you’ll have a lump sticking out of a weak area or hole in your tummy wall. This lump may contain your tummy lining, some fat or even a loop of your bowel.

Umbilical hernias are common in babies, but these usually go away on their own without needing any treatment. If the hernia doesn’t go away, a child may need surgery.

If you have an umbilical hernia as an adult, a piece of your bowel may get stuck in the hernia. This is called a strangulated hernia. A strangulated hernia can be dangerous and needs emergency surgery. To reduce your chances of having a strangulated hernia, your surgeon may advise you to have umbilical hernia repair surgery.

During an umbilical hernia repair operation, your surgeon will push the contents of the hernia back into your tummy. They’ll then repair the weak area in your tummy wall.

Preparation for umbilical hernia repair

Your surgeon will explain how to prepare for your umbilical hernia repair. If you smoke, they’ll advise you to stop. This is because smoking  may make you more likely to get a chest or wound infection, which can slow down your recovery.

An umbilical hernia repair is usually done as a day-case operation. This means you have the operation and go home on the same day. But you may need to stay longer depending on how complicated your hernia repair is. You’ll need to arrange for someone to take you home afterwards as you won’t be able to drive.

The surgery is usually done under general anaesthesia . This means you’ll be asleep during the operation. A general anaesthetic can sometimes make you sick, so your surgeon or hospital will give you clear instructions about eating and drinking before your operation. It’s important to follow their advice.

Your nurse or surgeon will discuss with you what will happen before, during and after your procedure, including any pain you may have. If you’re unsure about anything, it’s important to ask questions. Being fully informed about your surgery will help you feel more at ease and will allow you to give your consent for the procedure to go ahead. You may be asked to do this by signing a consent form.

Umbilical hernia repair

There are two ways of doing an umbilical hernia repair – open and keyhole (laparoscopic). Your surgeon will tell you which will be the best option for you. An open umbilical hernia repair usually takes about half an hour to 45 minutes and keyhole surgery takes about an hour.

Open surgery

Your surgeon will make a small cut just above or below your belly button and will push the hernia back into place. If the hernia is small, they’ll stitch the weak area in your abdominal wall. For a larger hernia, your surgeon will probably repair the area with a piece of synthetic mesh. They’ll close the cut, usually with dissolvable stitches, and cover it with a dressing.

Keyhole surgery

Your surgeon will make two to four small cuts in your tummy, away from the hernia. They’ll then insert a tube-like telescopic camera called a laparoscope, which shows the hernia on a screen. Your surgeon will put surgical instruments inside your tummy through the cuts to repair the hernia. They may pass carbon dioxide gas into your tummy to inflate it to help them see your hernia. Your surgeon will fix a synthetic mesh to the muscle around the hernia using staples or stitches. They’ll close the cuts, usually with dissolvable stitches, and cover it with a dressing.

Aftercare for umbilical hernia repair

After your umbilical hernia repair, you may feel some discomfort or pain as the anaesthetic wears off. Tell your nurse if you need some pain relief.

You’ll usually be able to go home the same day you have the operation, as soon as you feel ready.

If your hernia was large or the repair was complicated, you may have a fine drainage tube sticking out from the wound. You may need to stay in hospital until this is taken out. Ask your surgeon for more information if you have a drainage tube..

The medicines used for general anaesthesia can stay in your body for a while. Do not drive, drink alcohol, operate machinery or make important decisions for 24 hours after your anaesthetic.

Your nurse will give you advice about  before you go home. It’s important to keep the area of your operation clean and dry after your operation. You may need to avoid swimming or soaking in a bath until any staples, stitches or dressings have been removed. You may be given a date for a follow-up appointment.

Dissolvable stitches will usually take up to three weeks to disappear.

Recovering from umbilical hernia repair

Everyone recovers differently from umbilical hernia surgery. You may recover in a few weeks, or it may take you a few months to get back to your usual activities. How long this takes will depend on your general health and how complicated your surgery was.

You’ll have small scars. These will heal in around four to six weeks. The scars will usually get softer and fade gradually for up to a year. If you had open surgery, the size of your scar will depend on how big your hernia was. If you had keyhole surgery, most scars are 0.5 to 1cm.

Easing any discomfort

You may get some pain in the first few days after your umbilical hernia repair. If you need pain relief, you can take  , such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

You may find it helpful to hold your hand over your tummy when you cough or move for a while after your surgery. This can give you support to ease any discomfort.

It’s important to try to avoid  after an umbilical hernia repair. This is because straining to do a poo can put pressure on the part of your tummy where you had surgery. So eat plenty of fresh fruit and vegetables and  . If you’re finding it hard to poo, you may be able to take a mild laxative, but check with a doctor or pharmacist first.

Back to your routine

Getting back to your normal routine can help you recover from surgery. But you’ll need to take it easy in the first few days. And when you start doing more activities, build these up slowly.

You may be able to get back to your normal activities after a week or two as long as these don’t cause you any pain. You should be able to go for walks, a gentle jog, a light bike ride or exercise in the first two weeks but check with your surgeon. Stretching, bending down and using your tummy muscles may feel uncomfortable at first but will get easier over time.

Your surgeon will give you advice about which activities you shouldn’t do at first. They may advise you to wait for six to eight weeks before you do any strenuous exercise, weightlifting, hard cycling and strenuous swimming. You should also wait six weeks before you have sex to allow yourself time to recover from your operation. If you had a larger umbilical hernia repair, you may need to wait up to eight weeks to do these activities.

Getting back to normal

You should be able to go back to work once you feel up to it. Your surgeon will be able to give you the right advice to fit in with your job and lifestyle. You may feel ready for light work a few days after your surgery. But it may take you longer to return if your work is strenuous and involves heavy lifting or puts a strain on your tummy muscles.

Children should stay off school for a week after an umbilical hernia repair. They shouldn’t do any strenuous activities for six weeks.

You shouldn’t drive until you’ve recovered well enough to be completely in control of your vehicle. Ask your surgeon for their advice on when you can drive again. The  may also be able to give you some advice.

Side-effects of umbilical hernia repair

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. After an umbilical hernia repair, you may have:

• some pain, discomfort and bruising in your tummy – this should gradually get better after a couple of weeks
• some tightness in your tummy muscles like you’ve done sit-ups – this is completely normal and will usually settle down after a couple of weeks
• some numbness around your belly button – this will take a while to get better and, with some larger hernias, may not go away completely

If you had keyhole surgery, you may get pain in your shoulder because of the carbon dioxide gas your surgeon put inside your tummy during the procedure. It may help to get up and walk around a bit to ease this.

Complications of umbilical hernia repair

Complications are when problems occur during or after the operation. Your surgeon will let you know how likely these are to happen.

Complications of an umbilical hernia repair include the following.

• Your wound may get infected. It may be red, painful and swollen and have a discharge coming from it. You’ll need some antibiotics to treat it. You may be less likely to get a wound infection if you have keyhole surgery.
• Your wound may bleed after the operation.
• Your umbilical hernia may come back – called a recurrent hernia. This is more likely to happen if you smoke, are overweight or your wound gets infected. If your surgeon has used mesh to repair your hernia, the hernia is probably less likely to come back. If it does come back, you’ll probably need to have another operation (recurrent umbilical hernia repair), usually with keyhole surgery.
• You may get a collection of fluid, called a seroma, under your wound. This may go away on its own or may need to be drained with a needle.

Contact your hospital or doctor if you:

• have pain that doesn’t go away or gets worse
• have stomach cramps
• have a raised temperature or chills
• keep vomiting
• have a smelly discharge coming from your wound, or it looks red and swollen
• haven’t been to the toilet to poo for three days after your operation

Alternatives to umbilical hernia repair

In young children, umbilical hernias often get better on their own, so they may not need surgery. Children may need an operation if the hernia doesn’t go away by the time they’re five years old, or if their hernia is bigger than 2cm.

In adults, the only way to get rid of an umbilical hernia is to have surgery to repair the weakness in the tummy wall. Having an umbilical hernia repair reduces the chance of getting serious complications if a piece of bowel or other tissue gets trapped.

If you’re pregnant and have an umbilical hernia, you’ll usually be advised to wait for surgery until after you’ve given birth. This is because a general anaesthetic could affect your baby’s health. Having a hernia shouldn’t affect the delivery of your baby. You’ll usually only need to have the operation during pregnancy if the hernia is strangulated (when a piece of your bowel gets stuck in the hernia).