When internal tissue extrudes through a weak spot in the muscles or fascia in the abdominal wall, causing a visible protrusion or bulge near the belly button (the umbilicus), it can be surgically corrected with an umbilical hernia repair (aka herniorrhaphy).
Umbilical hernias are very common in newborn babies. Many times, baby umbilical hernias repair on their own, but if they don’t by age 3 or 4, a doctor may suggest surgical repair.
Ten percent of all adult hernias are umbilical hernias. Some just look like an outie belly button, but they can flare up due to multiple pregnancies, age (as muscles weaken overtime), obesity, chronic straining from lifting or exercise, ascites (excess fluid in the belly), and genetics.Â
In otherwise healthy patients, umbilical hernia repairs are sometimes combined with cosmetic body contouring procedures, such as a tummy tuck or liposuction. Some patients (especially moms) may also opt to combine it with diastasis recti repair, to bring separated abdominal muscles back into alignment.
A small umbilical hernia can be relatively harmless. If the hernia grows in size and the muscle tightens around it, it can become painful and dangerous.
The biggest risk is a life-threatening condition known as a strangulated hernia, in which a part of the intestine is trapped in the hernia sac and loses its blood supply. Umbilical hernia repair surgery prevents this kind of serious complication.
Not always. If a hernia is small and innocuous, your doctor may take a wait-and-see approach.Â
If it’s large or causing discomfort, surgery is very likely your best option.Â
A sudden onset of pain and vomiting can indicate strangulation of the intestine, which requires emergency surgery.
Pros
ConsÂ
Umbilical hernia repair is usually considered medical necessity, so it's typically covered by health insurance.
That said, levels of coverage and copays vary. Reach out to your insurance provider for details on what would be covered and which surgeons are in their network.
First, your surgeon will take an X-ray to determine the exact location and size of the hernia.
There are two different surgical techniques: an open repair, in which the surgeon makes an incision near the hernia and pushes the tissue back into the abdominal cavity, and a laparoscopic repair, where the surgeon makes a few small incisions through which to insert tubes with lighted cameras.
An open repair can be performed under local anesthesia with sedation, a spinal block, or general anesthesia. Laparoscopic surgery is always done under general anesthesia.Â
In both cases, the fascia over the weakened abdominal muscles is sutured back together and surgical mesh may be placed, to strengthen the weakened abdominal tissue and prevent future hernias. The skin is then sutured or closed with surgical glue.Â
Once you're in the recovery room, your blood pressure and heart rate will be monitored. You should be able to go home the same day, but a hospital stay might be recommended by your healthcare provider if the hernia is especially large or if you have a risk of complications due to health issues like diabetes.
You'll be given local or general anesthesia during the surgery, so you'll either be relaxed and comfortable or fully asleep.
You’ll feel sore once the anesthetic wears off, but post-op pain can be managed with an OTC pain medication like ibuprofen, as directed by your doctor.Â
If the surgical area feels especially tender or painful for more than a few days, talk with your surgeon. This could be a sign of an infection, seroma, or an issue with the surgical mesh.
You’ll need to take a week or two off work (depending on whether you have an open or laparoscopic procedure), resuming your normal activities only once you’re pain-free. Â
Avoid strenuous exercise for four to six weeks, since straining your incisions could lead to separation or other complications.
Updated June 13, 2023