MBBS FRACS • Upper Gastrointestinal, Advanced Laparoscopic and General Surgery • Perth, Western Australia

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Umbilical and ventral hernia

An umbilical hernia presents as a lump in the belly button with associated pain or discomfort.
Similarly a ventral (epigastric) hernia presents in the space between the belly button and the rib margins in the midline. It normally contains fat. However large hernia may contain other abdominal organs such as small bowel or stomach.

It may also be associated with recti diastasis (please see: recti diastasis).
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Repair of umbilical and ventral hernias

Umbilical and ventral hernias may be repaired through an open (traditional) method or by laparoscopic (keyhole) technique.

The choice of which technique to be employed for the repair will be discussed thoroughly at your consultation session. The factors taken into consideration are:
  • the size of the hernia
  • the number of hernias
  • whether there is any associated recti diastasis (please see: recti diastasis)
  • possible complications of each technique
  • patient choice.

Open umbilical/epigastric repair

This approach is used to repair small umbilical hernia without recti diastasis.
For repair of a large hernia or hernia with recti diastasis please see: Abdominal Wall Reconstruction/Component Separation Repair.

A small incision is made just below/through the umbilicus (belly button) or over the epigastric hernia lump. The hernia is then dissected off the surrounding tissue including the belly button. It is then reduced (pushed back into the abdomen). A mesh is placed deep to the muscle layer.

The hernia defect is then closed with sutures. The incision is then closed with sutures.

Laparoscopic repair

Three incisions are made in the left side of the abdominal wall, away from the hernia site.

Gas is then introduced into the abdominal cavity, elevating the abdominal wall muscle away from the abdominal organs. The hernia content is identified (structures passing from the abdominal cavity to the abdominal wall and through the abdominal wall muscular defect). This is carefully pulled back into the abdominal cavity leaving the hernia defect exposed.

The hernia defect is then closed laparoscopically (from the inside). The hernia defect is then covered with mesh that is secured to overlying muscle with sutures and special clips (these dissolve by themselves).

Possible complications

Open umbilical/epigastric repair

Infection—this tends to occur around the belly button. This will require antibiotics.

Fluid collection (seroma) under the wound. In most patients, the body will reabsorb this. Occasionally an intervention may be needed.

Recurrence of the hernia. The use of mesh should reduce this rate to less then 2%.

Laparoscopic repair

  • Wound infection
  • Mesh infection
  • Wound haematoma/seroma
  • Hernia recurrence
  • Damage to abdominal organs. This may require an open major operative correction.

Postoperative care

Open umbilical/ventral repair

The patient should expect to have some discomfort for one to two weeks. This can be alleviated with some oral pain relief.

The patient is encouraged to be active. (With restrictions of no heavy lifting for 4–6 weeks). However, caution is also advised when participating in exercise.

Please also see: Hernia – overview

Laparoscopic repair

The patient should expect to have some discomfort for one to two weeks. This can be alleviated with some oral pain relief, prescription given on discharge from hospital.

The patient is encouraged to be active. (With restrictions of no heavy lifting for 3 weeks). Caution is advised when participating in exercise.

The patient is typically reviewed 2–3 weeks after the operation.
Note: Patient will be given a post-operative management instruction sheet prior to the operation.

Please also see: Hernia – overview
Mr Hairul Ahmad MBBS FRACS
Upper Gastrointestinal, Advanced Laparoscopic and General Surgery
Perth, Western Australia
Practice Details

Suite 12, Waikiki Specialist Centre,
221 Willmott Drive, Waikiki WA 6169

Please call (08) 9592 2298 for an appointment.
Fax: (08) 6314 1524
or email us

Office hours

9am–4pm Monday to Friday

Affiliations
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