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Umbilical Hernia: Should I Have Surgery?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Umbilical Hernia: Should I Have Surgery?
Get the facts
- Have surgery now to repair your umbilical hernia, even if you don't have symptoms.
- Take a "wait and see" approach to surgery because the hernia doesn't bother you much.
Key points to remember
- Hernias don't go away on their own. Only surgery can repair a hernia.
- Many people are able to delay surgery for months or even years. And some people may never need surgery for a small hernia. If the hernia is small and you don't have any symptoms, or if the symptoms don't bother you much, you and your doctor may simply continue to watch for symptoms to occur.
- Over time, hernias tend to get bigger as the muscle wall of the belly gets weaker and more tissue bulges through.
- Many doctors recommend surgery because it prevents a rare but serious problem called strangulation. This occurs when a part of intestine or a piece of fatty tissue is trapped inside the hernia and is cut off from its blood supply.
An umbilical hernia is a bulge near the belly button, or navel. The hernia has a sac that may hold some intestine, fat, or fluid. These tissues may bulge through an opening or a weak spot in the stomach muscles. You may have had this weak spot since you were born, when muscle and other tissue around your umbilical cord didn't close properly.
In adults, umbilical hernias are more common in women who have been pregnant several times, in people who are overweight, and in people who have had surgery in the belly.
Repairing the hernia can relieve pain and discomfort and make the bulge go away. The hernia won't heal on its own.
Your doctor may recommend surgery if:
- Your hernia is very large.
- Your hernia bothers you.
Your doctor will recommend surgery right away if:
- You have pain, a swollen belly, or other signs of a rare but major problem called strangulation or incarcerated hernia. This can occur when the intestine gets trapped in the hernia sac and loses its blood supply.
During the surgery, the doctor makes a small cut, or incision, just below the belly button. Any tissue that bulges into the hernia sac is pushed back inside the belly. The muscles and tissues around the belly button are repaired, and the cut is closed with stitches.
Usually there is only a small scar, but if the hernia is very large, the belly button may not look normal. Most of the time, a surgeon can fix this. This surgery has few risks.
There are two types of hernia repair surgeries:
- Open hernia repair surgery. The hernia is repaired through a cut (incision) in the belly. Open surgery is safe and effective and has been done for many years.
- Laparoscopic hernia repair. A surgeon inserts a thin, lighted scope through a small incision in the belly. Surgical tools to repair the hernia are inserted through other small incisions in the belly. Laparoscopic hernia surgery may have some advantages over open surgery in certain cases. Studies show that people have less pain after this type of surgery and can return to work and other activities more quickly than after open repair. But this surgery costs more than open repair.
It can take up to 4 weeks after open hernia surgery before you can begin normal strenuous activities. If you have laparoscopic surgery, you may recover sooner.
You and your doctor may want to put off surgery if:
- The hernia is small and you don't have any symptoms, or if the symptoms don't bother you much.
- The hernia can be pushed back into the belly or it goes away when you lie down. (If it cannot be pushed back, surgery must be done sooner.)
It may also be a good idea to put off surgery if:
- You are pregnant.
- You have other health problems that make surgery dangerous.
Talk with your doctor before wearing a corset or truss for a hernia. These devices aren't recommended for treating hernias and sometimes can do more harm than good. There may be certain cases when your doctor thinks a truss would work, but these are rare.
Your hernia may get worse, but it may not. Over time, hernias tend to get bigger as the muscle wall of the belly gets weaker and more tissue bulges through. But some small, painless hernias never need repair.
Compare your options
What is usually involved?
What are the benefits?
What are the risks and side effects?
- You may be asleep during the operation. Or the doctor may keep you awake and simply numb the area around your belly button.
- You may have an epidural, which is medicine that numbs your body below the point of the injection. You may remain awake during the operation.
- You don't need to stay overnight in the hospital.
- Surgery prevents the rare but serious problem called strangulation.
- It relieves the bulge from the hernia and any swelling or feeling of heaviness, tugging, or burning in the area of the hernia.
- The hernia could come back.
Risks of surgery include:
- A bad reaction to the anesthesia.
- Infection and bleeding.
- Damage to the intestines or bladder if the surgery is a laparoscopic repair.
- You will get regular checkups to watch for changes.
- You watch for signs of problems related to the hernia, such as vomiting, pain, or a swollen belly.
- You don't have the risks or costs of surgery.
- A rare but serious problem called strangulation could occur.
Personal stories about considering umbilical hernia surgery
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I'm pregnant, and I have a small hernia that doesn't hurt. I've talked with my doctor about it, and she said I could have surgery as long as I have an epidural and not general anesthesia. But she said it may be best to wait until I'm done having kids. There's a risk I could get another hernia when I get pregnant again. So as long as my hernia doesn't get worse, I'll wait.
Brianna, age 32
I've had a hernia for a few years now. My doctor said it may have happened because I lost a lot of weight and my stomach muscles were weak. So I started exercising to try to get stronger, and I feel great. The hernia hasn't ever really bothered me, except for how it looks. So I don't feel like it's worth having surgery now.
Kassie, age 40
I've had a small umbilical hernia for several years but have basically ignored it. I'm not a big believer in letting people cut on my body, so I wanted to avoid surgery at all costs. But the hernia is really starting to bug me now, and it's gotten bigger and it looks weird. So I've got an appointment to talk to my doctor about surgery.
Antonio, age 56
I'm a nurse, and sometimes I have to lift patients and other heavy things. One day, after helping a patient transfer into a wheelchair, I felt something weird in my abdomen. Later, I noticed a bulge in my belly button. My doctor said it may have happened because I've gained quite a bit of weight lately. I've decided to go ahead and have it fixed since it's kind of painful and it could be a problem with my work.
Robert, age 45
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have surgery now
Reasons to wait
My hernia is keeping me from doing daily activities or from returning to work.
My hernia doesn't bother me at all.
I want to have the hernia repaired while my insurance or worker's compensation will help cover the costs.
I am worried about being able to afford the surgery.
I will be traveling to an area where health care may not be available, so I want to take care of this now.
I have no plans to travel to places where health care may not be available.
Surgery would be convenient for me at this time.
This is not a good time for me to have surgery.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery now
Waiting to have surgery
What else do you need to make your decision?
Check the facts
One reason for me to have surgery for my umbilical hernia is to prevent a rare but serious problem called strangulation.
- TrueYou're right. Many doctors recommend surgery because it prevents strangulation, which happens when a piece of tissue gets trapped inside the hernia and is cut off from its blood supply.
- FalseSorry, that's wrong. Many doctors recommend surgery because it prevents strangulation, which happens when a piece of tissue gets trapped inside the hernia and is cut off from its blood supply.
- I'm not sureIt may help to go back and read "Get the Facts." Many doctors recommend surgery because it prevents a problem called strangulation.
I need surgery even though my hernia is small and doesn't bother me.
- TrueNo, that's wrong. If your hernia is small and your symptoms don't bother you, you can delay surgery. Some people never need surgery.
- FalseYou're right. If your hernia is small and your symptoms don't bother you, you can delay surgery. Some people never need surgery.
- I'm not sureIt may help to go back and read "Get the Facts." If your hernia is small and your symptoms don't bother you, you can delay surgery. Some people never need surgery.
I can wait for my hernia to go away on its own.
- TrueSorry, that's wrong. An umbilical hernia won't go away on its own. Only surgery can repair it.
- FalseYou're right. An umbilical hernia won't go away on its own. Only surgery can repair it.
- I'm not sureIt may help to go back and read "Get the Facts." An umbilical hernia won't go away on its own. Only surgery can repair it.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
How sure do you feel right now about your decision?
Use the following space to list questions, concerns, and next steps.
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||Kenneth Bark, MD - Surgery, Colon and Rectal|