What are paraumbilical and umbilical hernias?

What are the benefits of surgery?

You should no longer have the hernia. Surgery should prevent the serious complications that a hernia can cause, helping you go back to your normal activities.

Are there any alternatives to surgery?

In children under the age of about 4, umbilical hernias normally close. For older children and adults, surgery is recommended as it is the only dependable way to cure the condition.

What will happen if I decide not to have the operation or the operation is delayed?

Sometimes, the hernia can get larger with time. It can also be dangerous because your intestines or other structures within your abdomen can get trapped and have their blood supply cut off.

Symptoms that may suggest a strangulated hernia are:

• severe pain
• a hernia that will not disappear when you lie down, and
• vomiting

What does the operation involve?

The procedure is usually performed under a general anaesthetic that sends you to sleep. However, different kinds of anaesthetics are possible.

The procedure usually takes about 30 minutes. Your surgeon will make a cut near your umbilicus. They will free up the ‘hernial sac’, place the contents back inside your abdomen and remove the hernial sac. Your surgeon will close the weak spot with strong stitches or a synthetic mesh and close your skin.

How can I prepare myself for the operation?

If you smoke, stopping now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the procedure, help you recover and improve your long-term health. Do not do exercises that involve heavy lifting or make your hernia painful. Before you start exercising, ask the healthcare team or your GP for advice.

What complications can happen?

The healthcare team are trained to reduce the risk of complications.

Any risk rates given are taken from studies of people who have had this procedure. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, you are obese, you smoke or you have other health problems. Health problems include diabetes, heart disease or lung disease.

Some complications may be serious and can even cause death.

General complications of any operation

• Bleeding during or after the procedure.
• Venous thromboembolism (VTE). This is a blood clot in your leg (deep-vein thrombosis, or DVT) or one that has moved to your lung (pulmonary embolus).
• Infection of the surgical wound.
• Chest infection. Your risk is lower if you do not smoke or have stopped smoking, and have not had a recent cough or cold.

Specific complications of this operation

• Developing a collection of blood (haematoma) or fluid (seroma) under your wound.
• Injury to your bowel.
• Infection of the mesh.
• Removing your umbilicus. Sometimes your umbilicus needs to be completely removed.
• The hernia coming back. The hernia can come back many years later and you may need another procedure.

Consequences of this procedure

• Pain.
• Scarring of your skin.

How soon will I recover?

You should be able to go home the same day.

Increase how much you walk around over the first few days.

You should be able to return to work and normal activities after 2 weeks to 4 weeks, depending on your recovery and the type of work you do.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Summary

A hernia near your umbilicus is a common condition caused by a weakness in your abdominal wall. If left untreated, a hernia near your umbilicus can cause serious complications.

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