An umbilical hernia, also known as belly button hernia presents in or around the navel or umbilicus.
An umbilical hernia occurs when organs present in our abdomen or fatty tissue comes out through a small hole in the abdominal wall around the navel area.
This small hole or defect present in the abdominal wall can be acquired as the result of a sudden or repetitive lifting, straining or as a result of chronic cough or constipation.
However, some umbilical hernias can also be congenital (present at birth).
Even pregnancy can also result in umbilical hernias due to the pressure of the expanding womb against the naval or abdominal wall.
As hernia progresses with time, the protrusion becomes so extreme that it distorts the navel resulting an “outie” instead of an “innie”. Adult umbilical hernias can become problematic when incarceration or strangulation occurs.
Treatment of Umbilical hernia
In case of a small hernia with a size less than 1 cm and not causing any problems or symptoms, no treatment is required. However invariably these hernias gradually progresses with time and may then become painful.
The decision on whether to operate or not should be taken depending upon the symptoms and size of hernia and patients must understand the benefits of early repair and sometimes the risk associated with delay in treatment.
Similar to other types of hernia, umbilical hernia can be repaired either by conventional open technique or by laparoscopic approach.
Conventional open method:
If an umbilical hernia measures less than 2 cm diameter at its base, then we repair it using a very simple and safe open technique.
A small cut is made in the upper or lower crease of the umbilicus. The contents of hernia are pushed back inside the abdomen and the weakness is repaired with simple suturing. There is no need of any mesh to reinforce the defect.
If the hernia is larger than 2cm then we recommend a laparoscopic, or key hole surgery technique to repair it.
This involves placing 3 small cuts or holes measuring 5 to 10mm on the left side of the abdomen. The hernia contents are reduced and the hernia defect is reinforced with a light weight mesh which is secured on the inside underneath the hernia.
The mesh encourages scar tissue to form and therefore strengthens the whole area, decreasing the chance of a recurrence of the hernia.
We usually advise to place a composite mesh so as to prevent post-operative bowel adhesion or bowel erosion.
These composite mesh have absorbable collagen barrier on one side to limit visceral or bowel attachments, and a polyester knit structure on the other to promote differentiated tissue in growth.
Its unique polyester material works with the body’s natural systems for true tissue integration and it is optimized to minimize shrinkage.