Information on Umbilical Hernias

Did you know?
Day-case surgery is possible for most umbilical hernias
Surgery at Ross Hall. Scotland’s premier hopsital
As many as 3 in 10 patients who get a hernia on one side will subsequently get a hernia on the opposite side
Most patients are fully active within days of the operation
We have a highly experienced surgical and nursing team

So, what is an umbilical hernia?

An umbilical hernia is a small opening in the abdominal wall at the umbilicus (belly button).

An umbilical hernia occurs when part of the intestine or fat within the abdomen protrudes through a weak spot in the abdominal muscles. It appears as a soft swelling in the area of the umbilicus (belly button).

This type of hernia can occur in infants and adults. It is often most visible when a child cries or strains, as the pressure pushes the abdominal contents or fluid through the hole causing it to bulge. In adults, it is usually visible when standing and may or may not disappear when lying down. It may become tender when lifting weights or heavy objects.

Occasionally, the protruding abdominal tissue becomes trapped (incarcerated) and can no longer be pushed back into the abdominal cavity. This reduces the blood supply to the section of trapped intestine and can lead to tissue death. Emergency surgery may be required. You may also need emergency surgery if you develop signs and symptoms of bowel obstruction. These include abdominal cramps, bloating and vomiting.

Want to see a specialist about your hernia?

Contact our Specialist Surgeons at the Scottish Hernia Centre

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Umbilical hernia

Increasing weight is the most important factor that predisposes to getting this type of hernia

Not sure if you have a hernia?

Your GP will usually be able to confirm if you have a hernia.

We are also happy to see you without the need to first see your GP.

Umbilical hernias are often small and are not noticed

Who is likely to get an umbilical hernia?

Umbilical hernia may occur in children and adults. They often develop in pregnant women or women who had had children in the past. Increasing weight however is the most common reason for the development of an umbilical hernia.

Rarer causes include fluid in the abdomen (ascities). Treatment for adults typically is surgery, especially if the hernia enlarges and causes pain. Hernias rarely go away without treatment.

What are the symptoms of an umbilical hernia?

Most umbilical hernias have no symptoms. The development of pain in an umbilical hernia is a cause for concern as it suggest the the hernia has become incarcerated or trapped. This can progress and may require emergency surgery.

Mostly, people are concerned about the appearance. For children, it is usually the parents and grandparents who are concerned. The hernia may get tight when coughing or lifting objects. Incarceration (abdominal contents getting stuck in the hernia) can occur and will very rapidly lead to severe pain. An emergency operation is usually necessary in these circumstances.

How are umbilical hernias treated?

Small umbilical hernias can be observed, especially in children as many will close by the age of 5 years. In adults, umbilical hernias will not close and may get bigger. This is especially so if increasing weight is the cause and a persons weight continues to rise. In adults, consideration should be given to closing these hernias if they are causing pain or discomfort or they are increasing in size.

Surgery is usually performed as a day case under general anaesthetic. A synthetic mesh is used to reinforce the repair in most patients as this reduced the risk of the hernia coming back. Most operations are performed as an open mesh repair. However, larger and recurrent umbilical hernias are often best treated with a laparoscopic or keyhole repair.

Emergency hernia surgery

Can an umbilical hernia cause a serious problem?

Most abdominal hernias appear suddenly when the abdominal muscles are strained or if you have been standing for some time. You may feel tenderness, a slight burning sensation, or a feeling of heaviness in the bulge. It may be possible to push the hernia back into place with gentle pressure, or the hernia may disappear by itself when you lie down. Being able to push the hernia back is called reducing it. On the other hand, some hernias cannot be pushed back into place, and are termed incarcerated or irreducible.

Most hernias do not cause too much pain and many cause no pain at all. Persistent, severe or increasing discomfort is a worrying feature and might indicate that the hernia has become “stuck” or incarcerated. This situation can progress to the development of tissue damage or even gangrene within the hernia which becomes a surgical emergency. If a hernia becomes increasingly painful which is not relieved by lying down, you should seek immediate medical advice as this might be an indicator that it has become incarcerated.

What are the surgery options for an umbilical hernia?

Umbilical hernia surgery is usually performed as a day case, without the need for an overnight stay in hospital. General anaesthesia is usually used although local anaesthetic can be used for small open hernias.

Surgery is generally performed through a small 2-5 cm incision just below the umbilicus. The procedure involves freeing up the hernia from the umbilicus and returning the contents of the hernia (usually fatty tissue) back to the abdomen.

The weakness within the abdomen is then repaired. This repair is usually reinforced with by a mesh made of a synthetic material that does not irritate the body. Laparoscopic surgery, also known as “keyhole” or “minimally invasive” surgery, may also be used.

Are there any non-surgical options to treat an umbilical hernia?

In adults, the hernia is very unlikely to go away on its own. It may stay unchanged and give rise to similar symptoms that you are currently getting. If left alone, you run the risk that it may get bigger and cause increasing discomfort.

There is a small chance that the contents of the hernia could become strangulated. This would require emergency and somewhat more complex surgery with a longer stay in hospital if it occurred.

Side view of an umbilical hernia containing small intestine

What can I expect after umbilical hernia surgery?

Most operations are done as a day case. These patients go home once they have recovered from the anaesthetic. Anyone who has a general anaesthetic will need to arrange for a friend or relative to drive them home and stay with them for the next 24 hours.

A general anaesthetic can temporarily affect co-ordination and reasoning skills, so we advise patients to avoid driving, drinking alcohol or signing legal documents for 24 hours. Before discharge, we will provide detailed advise about caring for the wound. We usually use invisible wound stitches so there will be no need for stitches to be removed. An appointment for clinic review will also be made (usually around six weeks later).

Whether recovering from open or laparoscopic surgery, it will be necessary to take it easy for the first two or three days. We will give you specific advice about resuming normal activities. In general you should be able to move around freely but should avoid strenuous exercise and lifting for at least the first few weeks. Most people continue to experience some discomfort for a few weeks after surgery, but this will gradually settle.

In experienced hands, the long-term success rate for surgery is high with a less than 5% risk of the hernia coming back again.

Hernia surgery

What are the side-effects or complications of surgery?

Side-effects of surgery:

Side-effects are the unwanted but usually temporary effects of a successful procedure. Examples include feeling sick as a result of the general anaesthetic or painkillers.

Complications of umbilical hernia surgery:

Complications are unexpected problems that can occur during or after the operation. However, most people undergo femoral hernia without difficulty. As with any surgery, there is a very small risk of developing an unexpected reaction to the anaesthetic. Other rarely encountered problems include excessive bleeding, infection or developing a blood clot within the leg veins (deep vein thrombosis). To help prevent this, most people are given compression stockings to wear during the operation. They may also be given a drug to thin the blood and reduce the risk of clots.

Specific complications of an umbilical hernia repair are uncommon but can include accidental damage to internal organs, which could require a larger incision to repair. There is also a risk of abdominal bruising, although this usually settles without treatment.

The chance of complications depends on the exact type of operation you are having and other factors such as your general health. There is a small risk of infection in the mesh which can be difficult to eradicate if it occurs. The umbilicus may not have a similar appearance after surgery compared to the appearance before the operation.

What can I do to avoid an umbilical hernia?

In most instances, there is no specific reason why umbilical hernias develop. For some, increasing weight may be a factor. However, iot is not inevitabel that you will develop a hernia if you put on weight. Sometimes, umbilical hernias may develop after pregnancy. Lifestyle measures may help to prevent an umbilical hernia from developing. The most important advice is to use lifting equipment for heavy loads. Use safe lifting and carrying techniques and avoid excessive or repeated straining.

Other factors that may help include the following

Maintaining muscle strength by taking regular daily exercise
Avoiding constipation by eating a healthy high-fibre diet that contains plenty of fruit, vegetables and whole grain cereals, such as wholemeal bread and brown rice
Stop smoking
Losing weight (if overweight)

Can I undergo umbilical hernia surgery at the Scottish Hernia Centre?

Yes. Richard Molloy undertakes umbilical hernia surgery on a regular basis at the Scottish Hernia Centre, based at Ross Hall hospital Glasgow. At the initial consultation, your hernia and any other medical problems will be assessed before discussing the surgical options for repair.

The Scottish Hernia Centre is Glasgow’s & Scotland’s premier private specialist hernia centre, where highly trained nursing and medical staff work within a state of the art hospital enabling our surgeons to safely treat even the most complex hernia within a safe and comfortable high tech environment.