Synonyms in a broader sense
- Umbilical hernia
- Outer hernia
- Intestinal Hernia
The therapy used for umbilical hernia depends strongly on the age at which it occurs and its size. For infants with an umbilical hernia, no action is usually taken, as there is only a very low risk of entrapment and it usually regresses spontaneously. However, if, for example, excessive crying of the child and the resulting high pressure in the abdomen prevents the hernia from sliding back into the abdomen, it is possible to administer a sedative to the infant.
With its help the baby can relax and the umbilical hernia will slide back. If the umbilical hernia does not disappear by itself, it is not treated surgically but with bandages. Only if the umbilical hernia persists until after the age of 3 years or causes severe pain before that time, surgery will be necessary in children as well.
However, this is a smaller operation, since the repair is only done by sewing over the hernia (as in adults with a very small defect). In adults, the regression no longer occurs spontaneously. The defect in the abdominal wall must therefore be surgically closed to prevent incarceration.
This is done by means of umbilical hernia surgery (umbilical hernia plastic surgery). The incision is made either vertically through the navel or along the edge of the navel. The umbilical hernia is then displayed together with its hernial orifice and the hernia sac.
The skin of the hernia sac is then detached. Then the hernia sac including its contents can be moved back into the abdominal cavity. The hernial orifice must be closed stably, whereby the physician has various techniques at his disposal (tobacco pouch suture, U-suture, backstitch suture, etc.).
If the hernial orifice was more than 3cm in size, additional stabilization with a plastic mesh should be used to prevent repeated fractures. In case of emergency surgery after an incarceration, those sections of the intestine that have died due to the lack of blood supply must be removed. For this purpose the entire abdomen must be opened.
Following an umbilical hernia operation, the patient should expose himself to as little physical stress as possible for at least six weeks. This means that he or she should refrain from heavy physical activities and sports and should also avoid increased pressing, as is often the case with bowel movements, for example. It is also advisable to pay particular attention to nutrition during this period, not only because excess weight increases the pressure in the abdominal cavity, but also because constipation or flatulence caused by the wrong diet can lead to a relapse.
In case of a larger hernia, the affected area can be supported by a body bandage for compression. As a rule, the operation is performed on an outpatient basis under short anaesthesia or local anaesthesia. However, in the event of an incarceration or known serious previous illnesses, it should be performed as an inpatient procedure.
