An umbilical hernia occurs when tissue, such as part of the intestine or fatty tissue, bulges through a weak spot in the abdominal muscles near the belly button. This weakness is typically present from birth, as the umbilical cord opening does not fully close. While often harmless, an umbilical hernia can become noticeable as a soft bulge, especially when coughing, crying, or straining. Its repair often involves specialized medical professionals.
The Specialists Who Repair Umbilical Hernias
The medical specialist who repairs an umbilical hernia depends on the patient’s age. For adults, a general surgeon performs umbilical hernia repairs. These surgeons are trained in abdominal wall procedures, diagnosing hernias, and developing treatment plans.
For infants and children, a pediatric surgeon is the appropriate specialist. Pediatric surgeons specialize in the surgical care of younger patients, understanding pediatric anatomy and growth considerations. This distinction is important because umbilical hernias in children often behave differently than in adults, and their repair requires a surgeon with expertise in treating developing bodies.
When Surgical Repair is Necessary
Not all umbilical hernias require immediate surgical intervention, particularly in infants. Many in babies, especially those smaller than 1 to 1.5 centimeters, will close on their own by the time a child is 3 to 5 years old. Watchful waiting is often advised.
Surgery is recommended if the hernia causes pain, becomes incarcerated (trapped), or shows signs of strangulation (blood supply cut off). For children, surgical repair may be considered if the hernia is very large, grows significantly after 1 to 2 years of age, or does not close by age 5. In adults, surgery is recommended to prevent complications, as adult umbilical hernias are unlikely to resolve on their own and carry a higher risk of complications.
Understanding the Repair Procedure
Surgical repair of an umbilical hernia involves a few steps. The surgeon makes a small incision near the belly button, often following natural skin lines. Protruding tissue, such as fat or intestine, is gently pushed back into the abdominal cavity.
After repositioning, the weakened abdominal wall is reinforced. For smaller defects, the surgeon stitches the muscle layers closed. For larger defects or in adults, surgical mesh may be placed for support and to reduce recurrence. This can be done via an open approach or, less commonly, laparoscopically.
What to Expect After Repair
After umbilical hernia repair, patients can expect some pain and discomfort for a few days, managed with medication. Swelling and abdominal tightness are common. Most umbilical hernia repairs are outpatient, allowing patients to return home the same day.
Activity restrictions are advised during recovery. Gentle activities like walking aid healing, but heavy lifting and strenuous activities are restricted for 4 to 6 weeks to allow proper healing. Full recovery varies, but many individuals can resume normal daily activities within one to two weeks. Patients should monitor the incision site for complications like fever, increased redness, swelling, or drainage, and contact their healthcare provider if these occur.