Umbilical Hernia

In this article I want to take a little time to discuss umbilical hernias.  Hopefully you have a good idea what a hernia is from my other article abdominal hernias.  If not, go back and read that article as it will give you a good idea about what exactly a hernia is, and why they may happen.

Ok, as you may have suspected, an umbilical hernia is a hernia at or around the belly button.  This is a pretty common occurrence that can happen pretty much at any age.

As a fetus, we receive our nutrients and blood supply through the umbilical cord.  The umbilical cord enters the abdomen at the belly button, and so there is a anatomical defect in the abdomen at that spot.  If it does not close completely after birth, the child will have an umbilical hernia. Thus, some children have an umbilical hernia from birth.  Many close spontaneously by the age of 2-3 years.  If it does not close by the age of 3, it is recommended that that child have the umbilical hernia surgically repaired.

Adults also acquire umbilical hernias.  These form due to a weakness in the wall of the abdomen at the site of the umbilical cord.   Since this is an anatomical weak part of the wall of the abdomen, we are more prone to hernias here.  If there is repeated increased pressure of the abdominal wall, this weak spot can become the site of the hernia.  This can happen in young athletic adults, pregnant women, or older adults.

The reason it is recommend the hernia is repaired is that the bowels or abdominal contents can go through the hernia (remember, it’s just a hole in the abdominal wall), and get trapped.  This can cut off the blood supply to whatever is trappe in the hernia….and if you cut off the blood supply to anything in the body, bad things can happen!

So essentially any hernia in the adult should be repaired surgically.  Many times the hernias are small and only a small incision either above or below the belly button is required.  For larger hernias of the umbilicus, open or laparoscopic surgery may be in order.  Depending on your hernia anatomy and your surgeons preference, any of these options may be appropriate.

Mesh or not to mesh is the question.  Some surgeons may have different opinions about this but I tend to reserve mesh for hernias over about 3 cm in diameter.  Smaller hernias can be repaired with just suture if done well and cared for properly post operatively.

The length of the surgery will depend on your hernia specific situation but many smaller umbilical hernias may be repaired in 30 minutes to 1 hour.  The surgery does require general anesthesia so the abdominal wall can be relaxed entirely.

Hopefully I’ve cleared up some questions you had about umbilical hernias.  You can see my post-operative umbilical hernia instructions here.

-Dr. Buck