Umbilical Hernia

The umbilicus is the weakest place in the abdomen, and hence Hernias can develop through this. Especially pregnancy and obesity can stretch the abdominal wall and cause a defect at Umbilicus, since it is not covered by any muscles.

  • It is through this defect that omentum (abdominal fat) or intestines can protrude and later on get stuck inside the hernia.
  • This hernia also goes on progressively enlarging. TN some cases the skin can be stretched , it can become dangerously thin and can break down, causing a wound (ulcer) on the hernia.
  • Umbilical Hernias can also poccur is patients having fluid (Ascitis) in abdomen.
  • Hernias can develop near or next to umbilicus when they are called as Paraumbilical Hernia. The treatment is similar to Umbilical hernia.
  • Umbilicus is the weakest part of abdominal wall. This small area is not covered by any muscles. A small hole (defect) can develop at umbilicus, either as a result of congenital ( birth defect) cause or it may occur due to stretching as happens in pregnancy or fluid accumulation due to disease process.
  • Fat (omentum) or state protruding out through this defect.
  • Slowly the defect enlarges and the fat or intestine gets stuck inside the cavity.
  • Occasionally it cause an emergency if the part of intestine stuck inside gets obstructed and its blood supply gets hampered. This will need emergency surgery.

Causes of Umbilical Hernia

  • Congenital defect
  • Obesity
  • Pregnancy
  • Conditions raising intra-abdominal pressure like Ascites, tumour, constipation, chronic,cough

Clinical features:

  • Swelling at umbilicus which appears in standing or coughing and disappears on lying down.   
  • Pain at umbilicus
  • Swelling at umbilicus of duration with progressive enlargement.
  • Sudden pain, redness, vomiting-all suggestive of obstruction.

Surgery for Umbilical Hernia:

  • After giving general anaesthesia, the abdomen is inflated by putting CO2 gas inside.
  • A telescope is inserted inside through 1cm opening. Two more punctures are made awy from Hernia and 2 instruments are put inside.
  • The fat or intestines stuck in the Hernia sac are released and pulled back inside the abdomen.
  • The opening of defects closed with long stitch.
  • A special Dual mesh is put inside the abdomen through the opening for camera, and spread. This mesh is then fixed on the abdominal wall from inside by stitches and a special screws called tackers.
  • Since this mesh is placed from inside it has a special layer to present intestines from sticking to the mesh.
  • Hence this mesh is very costly, so is the gun carrying the screws. Hence Laparoscopic repair is costly. however, the patient will be able to go home on next day, and join work in a weeks time.

If you want to see the video of this surgery, click herehttps://www.youtube.com/watch?v=dm_XjltDYfM&t=3s

Complications:

  • After surgery fluid can accumulates in the hernia sac, since it is now empty. This is called Seroma, and will go away slowly.
  • Pain can occur to carrying degree and may take longer time to go away.
  • If the mesh gets infected then if will have to be removed.