General Surgery

Umbilical or Paraumbilical Hernias

These are swellings found in or around the belly button. They can be present from birth or develop over time and sometimes occur after pregnancy.  Smaller ones usually contain a small amount of fat and can be left alone if not causing symptoms. Large ones can cause discomfort and are often felt to be unsightly.

Surgical Repair

Repair can be with strong sutures alone or with a synthetic mesh to reinforce the tissues if the defect is greater than 1cm in size. Often this is simplest to perform through a small cut underneath the tummy button where it will be least visible.

Open hernia repair – This is used in small uncomplicated hernias. The incision is usually underneath the belly button. The tummy button will be repaired but will not return completely to normal. Large complicated umbilical hernias may require removal of the belly button. Recovery time will depend on the size of the hernia. Dissolvable sutures are used to repair the skin and a waterproof dressing placed over the wound.

Laparoscopic (keyhole) repair – This usually reserved for recurrent hernias, especially when a mesh has been used previously. Small cuts are made in the abdominal wall to allow the passage of the instruments. The hernia is repaired using synthetic mesh and keyhole fixation devices. The cuts are repaired with dissolvable sutures and a local anaesthetic is given. A waterproof dressing is placed over the sites so you can shower straight away. These should be left for 3 days. On removal if the wound is not dry another dressing should be applied for a few more days.

Frequently Asked Questions

The secretary and hospital will organise a day for the procedure and give you the admission details. Routine blood tests and a heart tracing (ECG), maybe required before admission. You will be asked not to have anything to eat up to six hours prior to surgery. Water can be taken up to 2 hours prior to the surgery. The surgeon will go through the procedure again with you on the day and take your consent. The anaesthestist will also visit to discuss the general anaesthetic and your post surgery pain relief. It is also not uncommon for patients to require anti-sickness medications after a general anaesthetic.

Straightforward hernia repair is usually performed as a day procedure. You will be discharged once you are fully mobile and comfortable. Most patients require 2-3 days of simple pain medication but should be fully functional during this period. Some patients return to work after this, but it will depend on the type of repair and your occupation.

You will be discharged from hospital with a supply of simple pain-killers with instructions on how to use them. Regular paracetamol is particularly effective and can be combined with an anti-inflammatory drug (ibuprofen) or a codeine based drug (dihydrocodeine). Anti-inflammatories are not suitable for all patients and should be taken with food. The codeine-based drugs can cause constipation and should be taken with plenty of fluids.

Generally, it is recommended to take 2-3 days off work for straightforward repairs. Your ability to return to work will depend on your job and varies between individuals.

There are usually no restrictions on lifestyle or activities after a hernia has been repaired once recovery is complete. In larger repairs there may be some limitations. Strenuous activities (gym) should be avoided for 6 weeks.

Driving should be avoided in the first week after surgery. Once you can perform an emergency stop in a stationary vehicle and turn to view your blind spot then driving should be safe. It is preferable to contact your insurance company to check for any specific instructions they may have.

Straightforward repair carries a low risk of the hernia returning. Large hernia repairs can collect fluid around the surgical site after the operation. This is called a seroma. If it is sterile and not causing discomfort it is better left as it will gradually resolve. Infective complications are uncommon and usually treated with a prolonged course of antibiotics.

The hospital ward provides a 24/7 means of contact and will give you a contact number on discharge. They will contact the consultant about any concerns and are able to give advice if required. During working hours, the secretary will answer any queries.

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