What are paraumbilical and umbilical hernias?

Your abdominal cavity contains your intestines and other structures. These are protected by your abdominal wall, which is made up of four layers.

Weak spots can develop in the layer of muscle, resulting in the contents of your abdomen, along with the inner layer, pushing through your abdominal wall. This produces a lump called a hernia.

Paraumbilical and umbilical hernias are common as there is a natural weakness in the wall of your abdomen at your umbilicus. This is caused by the way babies develop in the womb.

You should no longer have the hernia. Surgery should prevent the serious complications that a hernia can cause and allow you to return to normal activities.

Are there any alternatives to surgery?

In children under the age of about 4, umbilical hernias tend to close. For older children and adults, surgery is recommended as it is the only dependable way to cure the condition.

What will happen if I decide not to have the operation or the operation is delayed?

Occasionally, the hernia can get larger with time. It can also be dangerous because your intestines or other structures within your abdomen can get trapped and have their blood supply cut off (strangulated hernia). The symptoms that may suggest a strangulated hernia are:

• severe pain
• a hernia that will not disappear when you lie down
• vomiting

If you have any of these symptoms you must call your healthcare team immediately as you may need an urgent operation.

If you are female and are planning to become pregnant, it is usually better to wait until after your pregnancy before having the operation. Pregnancy increases the size of your abdomen and may undo the hernia repair. Your surgeon will tell you the risks of delaying having the operation.

What does the operation involve?

The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible.

The operation usually takes about 30 minutes. Your surgeon will make a cut near your umbilicus. They will free up the 'hernial sac', place the contents back inside your abdomen and remove the hernial sac. Your surgeon will close the weak spot with strong stitches or a synthetic mesh and close your skin.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Do not do exercises that involve heavy lifting or make your hernia painful. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• bleeding
• blood clot in your leg
• blood clot in your lung
• infection of the surgical site (wound)
• chest infection

Specific complications of this operation

• developing a collection of blood (haematoma) or fluid (seroma) under your wound
• injury to your bowel
• infection of the mesh
• removing your umbilicus (belly button)

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You should be able to go home the same day.

Increase how much you walk around over the first few days.

You should be able to return to work after 2 to 4 weeks, depending on how much surgery you need and your type of work.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a full recovery and can return to normal activities. However, the hernia can come back.

Summary

A hernia near your umbilicus is a common condition caused by a weakness in your abdominal wall. If left untreated, a hernia near your umbilicus can cause serious complications.

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