What is an Umbilical Hernia?
An umbilical hernia is a hernia (protrusion of fat or intestine through a small hole in the abdominal wall layer called fascia) located in or near your belly button. Umbilical hernias are common and come in many sizes ranging from small (less than 1 cm) to medium (1 cm to 3 cm) to large (greater than 3cm).
There are many ways to repair a small umbilical hernia, and today it is more important than ever to make sure the technique being offered to you is the optimal one. Some techniques being offered may be more than what is necessary in some situations, so do your homework before agreeing to a surgery.
Umbilical hernias can be asymptomatic or cause pain. They can be reducible (able to push back in) or incarcerated (always out). Not all umbilical hernias need to be repaired. Discuss your umbilical hernia with Dr. Brian Jacob, our internationally recognized surgeon at NYC Hernia, to see if a repair is recommended. Most epigastric hernias are similar to umbilical hernias, slightly higher than the belly button. Recovery instructions after the repair for epigastric hernias are usually the same as for umbilical hernias.
What Do Umbilical Hernias Look Like?
Umbilical hernias can appear as a bulge or pain (or both) in your abdomen. Some have no symptoms at all.
Are There Treatment Options for An Umbilical Hernia?
Believe it or not, there are over 10 different treatment options that are considered standard when repairing an umbilical hernia, including:
- Open primary repair
- Open mesh repair (mesh can be placed inside your abdomen, between the muscle and peritoneum, or as an onlay on top of the fascia layer).
- Laparoscopic or robotic mesh repair. Both of these are considered minimally invasive surgery (MIS) repairs. (MIS) repairs can be done with or without defect closure. Mesh can be placed intra abdominal or between the peritoneum and muscle. Suture fixation, tack fixation, or a combination are common. Ask your surgeon about the technique and mesh they prefer for your case.
- Component separation is not necessary for many small umbilical hernias. Make sure to ask your surgeon if they are planning a component separation, and if so, why.
- If you also have a diastasis, with an umbilical hernia, in MANY cases of an umbilical hernia, you do not also need the diastasis repaired. Make sure to discuss this with your surgeon ahead of time.
- Imaging is useful only for certain cases of umbilical hernias, as most umbilical hernias can be diagnosed without an image (sonogram, CT scan, or MRI). If done, an image can help identify the hernia size, contents, and other hernias you may or may not also have.
What are the Risks of Umbilical Hernia Surgery?
Some surgical risks involved with removing an umbilical hernia include recurrences, chronic pain, bowel obstruction, enterotomy, mesh erosion, fistula, seroma, hematoma, and infection.
How Should I Prepare for My Umbilical Hernia Surgery?
To prepare yourself for surgery, you may want to discuss with our team of medical professionals if you have a BMI more than 35, as a higher BMI has the risk of an additional recurrence. Before surgery, you should quit smoking as well.
The night before your surgery, we advise that you take a shower and be sure to clean your belly button. You may take any of your usual medications unless instructed otherwise. However, don’t take any blood thinners before your surgery without consulting with Dr. Jacob first.
You can eat a normal meal for dinner, but should have no food or drink after midnight.
What Can I Expect From Umbilical Hernia Surgery?
On the day of your scheduled surgery, our staff at NYC Hernia will advise you to arrive at our facility one to two hours before your surgery.
What is Recovery Like After Umbilical Hernia Surgery?
You will wake up from general anesthesia in the recovery room (unless local anesthesia is used). Any immediate discomfort will be managed by the anesthesia and recovery room nursing teams. While in the recovery room, you may experience immediate postoperative nausea, pain, dizziness, and fatigue. These will all fade quickly. If you had general anesthesia, your throat may feel sore for up to 3 days. This is from the breathing tube and can be managed with lozenges or tea with honey. If you did not have general anesthesia, you will not experience this.
After your procedure, the nurses will monitor your vital signs, and eventually get you up from the stretcher into a chair, and then provide you with something light to drink. Within about 2 hours after surgery, you will be able to stand and even walk slowly.
You may be discharged after being able to void and drink liquids without significant nausea or vomiting, and after being able to walk without any dizziness. The average patient is discharged 2-4 hours after the surgery ends (some quicker, some slower).
We recommend no driving for the first 2-4 days, and certainly don’t drive while taking pain medication.
You will be given a prescription for pain medication. It has a side effect that includes, but is not limited to, nausea and constipation. Most patients report that they use a total of 5 tablets of this pain medication over the first 2 days after surgery, at which point they do not need any pain medication. Some patients report only needing to use extra-strength Tylenol® for several days.
What Should I Do At Home After My Surgery?
While we believe the recovery from an umbilical hernia repair is rapid, please allow yourself up to 3 weeks to feel completely normal/back to your baseline again.
Recovery times and experiences will always vary depending on patient, surgeon, and technique factors.
The typical recovery after an umbilical hernia repair is associated with mild to moderate incisional pain or mild discomfort. This may last anywhere from 2 – 14 days but is almost always gone by the 3rd or 4th week after surgery. By the 3-6 month postoperative visit, less than 0.1% of patients are symptomatic.
Because your incisions will have bandages on them, specific instructions for wound care will be provided upon discharge from NYC Hernia. In general, you may remove the outer bandage after 2 days, and the white tape or skin glue after 7-10 days. You may keep ice on the incision for the first day or two as needed. Make sure to follow up with our surgeon within the first 2 weeks after surgery.
How Soon Can I Eat After Umbilical Hernia Surgery?
Luckily, you may resume your normal diet when you feel ready after your procedure.
Will I Be Able to Walk After Surgery?
You will be able to stand, walk, and climb stairs with some mild discomfort starting the same night of surgery. You may shower the first day after surgery, but no bathing or swimming for 5 days.
Can I Exercise After My Procedure?
At NYC Hernia, we encourage you to try to walk, use a treadmill, or use a stationary bike without any resistance the first or second day after surgery. Heavier exercising at the gym, running, or lifting more than 25 pounds can generally resume without restriction after 3 to 4 weeks, or when completely pain-free, whichever occurs first.
How Soon Can I Return to Work After Surgery?
The majority of patients report that they are able to return to work without restrictions after 3 – 7 days.