Open Umbilical Hernia Repair/Surgery

Overview

You may have noticed a baby with a bulge or a lump around the belly button (umbilicus) area, which may appear soft in consistency without any pain or discomfort. According to a few research studies, about 20% of babies are born with this bulge or lump known as an “umbilical hernia."  An umbilical hernia presents with the classic sign of increased protrusion of the belly button when the baby cries, laughs, or strains while passing stools. Although they are most common in infants, they can also affect adults. An umbilical hernia usually closes on its own in the first two years of life but may sometimes remain open beyond five years, most often requiring an open surgical repair. 

Read on to learn more about an umbilical hernia and how it is treated through an open surgical repair, the benefits of the procedure, and the risks involved.

What Is An Umbilical Hernia?

During gestation (a period between conception and birth), the umbilical cord (a long, coiled, tube-like structure that connects the baby with the mother in the womb) passes through a tiny opening in the baby’s abdominal muscles, which normally closes immediately after birth. However, if the muscles do not join together or seal completely in the midline of the abdominal wall, it leads to the development of an umbilical hernia at birth or later in life. An umbilical hernia is an abnormal bulge or protrusion of the tissues around the belly button that pushes through the weakened abdominal muscles,  disrupting the protective barrier that holds the tissues in place.

In adults, it may be caused by increased intra-abdominal pressure that usually occurs due to obesity (being overweight), multiple pregnancies, previous surgery around the abdominal area, trauma, or a persistent, long-lasting cough.

How Is Umbilical Hernia Managed?

An umbilical hernia in infants and children is usually a painless, harmless condition that closes on its own around 1 or 2 years old. However, surgery is recommended if it continues beyond 5 years of age. 

Open surgical repair in children is recommended when the hernia:

• Is Painful 
• Is slightly larger in diameter (1 to 2 cm)
• Increases in size and does not subside over the first two years of life
• Does not disappear by 5 years of age
• Gets trapped or blocked within the intestine (strangulation)

In the case of adults, an umbilical hernia needs to be surgically repaired to avoid complications when the lump enlarges in size and becomes more painful.

Surgical repair of small umbilical hernias is usually performed through the traditional "open" surgical method.
 

What Is Meant By An Open Umbilical Hernia Repair?

An open umbilical hernia repair is an invasive procedure involving surgically opening the area within or below the belly button to correct the hernia. The hernia is accessed by making a large incision on the skin around the belly button.

• The procedure involves hospitalization for 1 to 2 days and is usually done under general anesthesia (a numbing agent that puts you to sleep during the surgical procedure).
• Your surgeon makes a large incision around the belly button that exposes the area to gain access to the surgical site.
• The healthy tissues are separated from your herniated (diseased) tissues, and the hernia contents are pushed back to their original position through the hole in the abdominal wall.
• Sometimes surgeons may place a mesh (synthetic material) near the belly button to prevent recurrence and also helps to strengthen the area around your abdomen in case of adults. Hernia mesh or surgical mesh is a flat, sterile sheet of plastic or biological material used to cover the hernia. The mesh also aids in decreasing the operative time and speeding up recovery time. Inserting the mesh is usually not recommended in infants and children. 
• The incision is closed through sutures (stitches).
• The hernia repair takes around 60 to 90 minutes, depending on the severity of the symptoms.

How To Prepare For An Open Umbilical Hernia Repair?

An open umbilical hernia repair is a safe procedure performed under general anesthesia. However, there are certain guidelines you or your child need to follow to prepare for the surgery, which reduce the anxiety associated with the procedure and aid in faster healing with minimal postoperative complications.

• Your surgeon will conduct a physical examination during your consultation to determine the extent and severity of the hernia.
• Your surgeon will review your or your child's medical history to check for any pre-existing condition like diabetes (increased blood sugar levels), hypertension (high blood pressure), asthma (a type of breathing issue), or other bleeding disorders to take necessary precautions during the surgery.
• Inform your surgeon about the history of drug allergies, medications, or any previous surgery.
• 1 to 2 weeks before the surgery, the following should be avoided:
  • Smoking and alcohol consumption
  • Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin
  • Herbal and vitamin supplements
• It is advisable to fast 6 to 8 hours before the surgery to prevent regurgitation of food when general anesthesia is given.
• Arrange leave from work or school for at least 2 weeks post-surgery.

What Happens After An Open Umbilical Hernia Repair?

An open umbilical hernia repair may require hospitalization for at least a day or two, depending on the severity of the condition.

• You or your child are kept in the recovery room for an hour or two until the effect of anesthesia wears off. Vitals, like pulse, blood pressure, etc., will be monitored.
• Mild bruising, pain, and swelling are normal and resolved with the help of pain medications and ice packs, respectively.
• You/your child can have a bath the next day since you will be given a waterproof dressing; however, avoid tub baths and swimming since this can lead to infections.
• Keep the bandage clean and dry; change it every 2 to 3 days.
• Return to your usual diet from the next day.
• Avoid lifting heavy objects and strenuous activities for 2 weeks.
• Make sure to be active to avoid blood clots.
• Complete recovery may take around 2 to 4 weeks.

What Are The Benefits And Risks Of An Open Umbilical Hernia

Repair

As with most surgeries, open umbilical hernia repair has its benefits and risks.

Benefits

• It is a safe procedure with very low chances of requiring repeat surgery.
• The chances of hernia recurrence are very low with open inguinal hernia repair.
• The cost of this surgery is lower compared to laparoscopic surgery.
• You can start ambulating early after an open umbilical hernia repair.
• Open inguinal hernia repair ensures good long-term benefits and a low risk of complications.
• Children and adults can resume school and jobs, respectively. Normal routine activities can be started within a few days of the surgery. Open umbilical hernia repair improves the quality of life in both children and adults.
• It prevents life-threatening complications of untreated umbilical hernia like obstruction (when the hernia is blocked or obstructed, a part of the protruded intestine gets trapped) and strangulation (when the trapped part of the intestine or other tissues is deprived of the blood supply). 

Risks 

Common

• Bruising, bleeding, and swelling around the surgical site
• A wound infection that may cause extreme pain, high-grade fever (more than 104 degrees), chills, and pus discharge
• Formation of hematoma (collection of blood around the site of the umbilical hernia)

Long-term

• Recurrence of the hernia
• Dislodgement or breaking down of the mesh (if used)

Rare but serious risks 

• Complications related to anesthesia that may cause severe shortness of breath
• Trauma or injury to the nearby structures and organs

Why Choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!