Image: You can see the findings during the umbilical hernia operation. This is a small umbilical hernia. 1, intra-abdominal fat (from the abdominal cavity). 2, hernial orifice: You can see the edge of the hernial orifice of the so-called linea alba of the abdominal wall. 3, abdominal cavity
What is an umbilical hernia?
can be a delicate membrane (peritoneum), abdominal fat (omentum majus) or, in the case of larger umbilical hernias, intestine. Pregnancy can lead to an umbilical hernia if the abdominal wall is overstretched.
Image: Abdominal hernia is favored by the overstretching of the abdominal wall during pregnancy.
Facts:
- Every 20th hernia is an umbilical hernia (5%).
- The factors that favor an umbilical hernia include: Pregnancy, obesity and heavy physical labor.
- The probability of incarceration after umbilical hernias is around 30%.
- In the event of an incarceration, 10-15% of patients die.
- In infants, these hernias heal in 98% of cases without therapy, in adults they never heal!
- A recurrence of an umbilical hernia after surgery is observed in approx. 3% of patients.
During tummy tuck surgery in Düsseldorf, we can often observe a belly button hernia, especially if it is performed after pregnancy. Our Düsseldorf team can then correct this as part of the primary operation. During liposuction in the abdominal area, we pay particular attention to gaps in the abdominal wall in order to prevent injury to internal organs through the cannulas via the hernia gap.
What complaints are caused by umbilical hernias?
An umbilical hernia does not always cause discomfort. Symptoms include pulling pain in the umbilical region. The pain caused by umbilical hernias occurs particularly during physical exertion, coughing and pressing. A protrusion is usually visible, but not always.
In the event of an incarceration with a subsequent circulatory disorder, the symptoms range from severe pain to an acute abdomen with a hard abdomen and shock. This is an emergency!
Image: Cross-section through the abdomen at the level of the navel. The umbilical hernia appears as a protrusion of the small intestine (4) between the straight abdominal muscles (3); 1, fatty tissue; 2, oblique and horizontal abdominal muscles.
The operation is also called umbilical hernioplasty.
As the probability of incarceration is quite high, the indication for surgery is given when the diagnosis is made. As part of hernia surgery, we can often operate on a small to medium-sized umbilical hernia at the Yuveo Clinic in Düsseldorf under local anesthesia or short anesthesia on an outpatient basis if there are no medical reasons not to do so.
The incision can be made vertically through the navel or at the edge of the navel. We then expose the hernial orifice and the hernial sac. We then detach the umbilicus from the abdominal wall and suture it back in place at the end. We move the hernia sac with its contents back into the abdominal cavity and then close the hernial orifice. Our plastic surgeons in Düsseldorf have various techniques at their disposal (tobacco bag suture, Mayo suture, back-stitch suture, U-suture and many more). If the hernial orifice is particularly large (larger than 3 cm), we can additionally stabilize it with a plastic mesh to prevent the formation of a new (abdominal) umbilical hernia and to secure this weak point.
Emergency surgery for umbilical hernia incarceration is more demanding. It is not uncommon for larger sections of intestine that are no longer supplied with blood and have protruded through the gap in the abdominal wall to be removed during an emergency hospital stay, whereby the entire abdomen is opened.
To avoid such an operation, it is advisable to operate on the hernia in good time.
Images: Common incisions in abdominal umbilical hernia surgery
What is the aftercare like following navel hernia surgery in Düsseldorf?
Following the umbilical hernia operation at our clinic in Düsseldorf, you should take it easy. You should refrain from pressing and heavy physical activity for approx. 6 weeks so that the healing of the umbilical hernia is not disturbed. If the hernia is larger, a compression bandage may also be useful. Please note: constipation and flatulence caused by poor nutrition can promote a recurrence of umbilical hernias.
Sources:
Pubmed:
- Anterolateral hernias of the abdomen – Mathonnet M, Mehinto D. – J Chir (Paris). 2007 Sep-Oct; 144 Spec No 4:5S19-22. review. French.
- Pediatric hernias – Brandt ML. – Surg Clin North Am. 2008 Feb;88(1):27-43, vii-viii. Review
- Umbilical hernia in adults:
Umbilical hernia in adults. – Lau H, Patil NG. – Surg Endosc. 2003 Dec;17(12):2016-20. Epub 2003 Oct 28. - Hernias – Schumpelick – Thieme – 2000
