What can I do for post-partum umbilical hernia repair?

Question

I'm 32weeks pg w/ my 3rd & last child, I developed an umbilical hernia while pg with #2. It never went away & many times is very painful. It has been suggested to opt for a c-section this time around to have the hernia repair done.  My question is two fold: A) is it simply better to wait 6-8weeks postpartum for the repair or B) is there another route other than forced c-section to fix after delivery, if the lap surgery is out patient & I'm there anyway can it be done next day

Otto Joseph Placik, MD · Answer

Only a few number of surgeons perform simultaneous repair due to concerns with contamination and your altered metabolism at the time of delivery. Most prefer to allow your system to return to baseline unless this is an incarcerated or strangulated hernia. However, this is only my opinion.

Raffy Karamanoukian, MD, FACS · Answer

Belly button hernia repair can be performed at the time of your delivery.  You may wish to undergo the procedure, followed by laser skin tightening of the abdominal skin after pregnancy.

Steven Wallach, MD · Answer

As far as the hernia goes, you can have it repaired after delivering. I would wait several months ( unless symptomatic) and have it done electively when your body has gone back to normal.

Peter A. Aldea, MD · Answer

Regarding: "I'm 32weeks pg w/ my 3rd & last child, I developed an umbilical hernia while pg with #2. It never went away & many times is very painful. It has been suggested to opt for a c-section this time around to have the hernia repair done.

	My question is two fold: A) is it simply better to wait 6-8weeks postpartum for the repair or B) is there another route other than forced c-section to fix after delivery, if the lap surgery is out patient & I'm there anyway can it be done next day" .

	No surgeon would advise you to have an elective umbilical hernia repair while pregnant. Per your history, this hernia appeared during you previous pregnancy and should have probably been repaired before your present pregnancy. The only reason for operating on this hernia before delivery would be the hernia being caught up (incarcerated) and especially if associated with possible tissue death (high white count etc). operating you otherwise could pose a serious threat to the baby.

	While the "I'm there anyway " theory is attractive and convenient, it does not take into account the anatomy and physiology of a recently pregnant abdomen and the needs of the baby. There is swelling of the abdomen and of vessels making surgery needlessly bloody. such surgery can result in complications that could deprive your baby from you in a very important bonding phase.

	it would be much safer to repair the hernia in a few months when your weight has stabilized. should you want to, it could even be repaired as part of a Tummy Tuck to give you your before the babies figure. 

	Good Luck.

	Dr. Peter a. Aldea

Aaron Stone, MD · Answer

Elective surgery is best done after recovery from delivery. During the process of delivery the body secretes hormones that loosen up to tissues to allow the baby to come out without tearing those tissues. Those same hormones hamper the healing process of any post partum surgery. If you wait until your body has completely recovered from the pregnancy your end surgical result should be better with less risk of a complication. The hernia recurrence rate will be much higher if it is repaired right after the delivery.

What can I do for post-partum umbilical hernia repair?

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