This type of hernias occurs at the umbilicus (congenitally weak area). When part of the intestine or momentum (Fatty apron inside the abdomen) protrudes out through the weak spot in the abdominal wall at the belly button, the condition is called an umbilical hernia. This is commonly seen in children and adult females often after childbirth.
The patient has a bulge at the umbilicus which disappears while lying down (at least in the initial stages) and increases when the patient applies pressure on the abdomen). Intestines can come out through the defect and stuck within the bulge and can lead to the intestinal obstruction which leads to abdominal distension, vomiting, and obstipation (not passing flatus and stool). If the blood supply to the intestine is compromised, it is called as 'strangulated hernia', which is a life-threatening condition. Patients with cirrhosis (shrunken liver) develop umbilical hernia due to pressure from excess fluid accumulation inside the abdomen (ascites). In these patients, sometimes the skin over the umbilicus thinned out and give way leading to fluid leakage. Surgical repair on an urgent basis needs to be done to correct this.
Surgical repair is usually advised.
Through a sub umbilical incision, hernia explored. Contents are reduced back. Hernial opening approximated with non-absorbable sutures. If the defect is small (<2cm), anatomical repair is adequate. Larger defects need reinforcement using a prosthetic mesh, usually made up of polypropylene. This surgery can be done under general or regional anesthesia. In females who have a pendulous abdomen, hernia repair procedure can be combined with abdominoplasty (contour correction). Abdominoplasty requires a large, suprapubic transverse incision
It is the most popular repair nowadays. This is always under general anesthesia. The hernial repair will be done through 3 small holes (one 10 mm and two 5 mm). Sometimes, in complicated hernias, additional holes may be required. The abdomen is inflated with carbon dioxide gas. Protruding organs are put back in position. Defect covered with a special prosthetic mesh adequately on all sides and fixed with sutures and/or tackers. Recovery is quicker with this approach hence the hospital stay is reduced and the patient can regain their work earlier compared to open repair. There will only be small scars.
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