Hernia, umbilical repair

Page last reviewed: 13/07/2011

A hernia is when an internal part of the body, such as an organ, pushes through a weakness in the muscle or surrounding tissue wall.

What is an umbilical hernia?

An umbilical hernia occurs when fatty tissue or a part of the bowel pokes through into an area near the navel (belly button). It pushes through a weak spot in the surrounding muscle wall (abdominal wall).

Umbilical hernias are very common in infants, with one in 10 young children being affected. They are especially common in babies who are premature (born early).

During pregnancy, the umbilical cord passes through an opening in the baby's abdominal wall. This opening should close before birth, but in some cases the muscles do not seal completely. This leaves a weak spot, which can lead to the development of an umbilical hernia.

The hernia appears as a lump in the navel that may get bigger when your child is laughing, coughing, crying or using the toilet. It may shrink when your child is relaxed or lying down. It is not painful.

Occasionally, an umbilical hernia can develop in adults. The following factors make this more likely to happen:

  • being overweight,
  • lifting heavy objects,
  • having a persistent cough, and
  • having a multiple pregnancy.

These pages focus on umbilical hernia repair in children.

Repairing the umbilical hernia

An umbilical hernia repair is a small operation to push the bulge back into place and to strengthen the abdominal wall.

In many cases of umbilical hernia in children, the operation is not necessary. Nine out of 10 umbilical hernias heal without treatment by the time the child reaches three or four years of age. Your surgeon will usually advise you to wait for your child to reach this age before considering having an operation.

In most cases, the umbilical hernia retracts (goes back in) and the muscles re-seal before the child's first birthday.

However, in very rare cases, the bit of bowel can get stuck outside the abdomen. This causes pain and vomiting, and could result in damage to your child's bowel. To prevent bowel damage, your child will need to have the operation straight away.

Outlook

An umbilical hernia repair is a very successful operation, and complications are rare. After the operation, the bulge will disappear and the belly button should look normal.

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Page last reviewed: 13/07/2011

Umbilical hernia repair is a fairly quick and simple operation, and your child will usually be able to go home the same day.

You will be asked to bring your child into hospital without giving them food for four to six hours beforehand. They can have water for up to two hours before surgery.

At hospital, you will meet your child's nurse, anaesthetist (specialist who will put your child to sleep) and surgeon. Your child will be given a general anaesthetic (put to sleep) while you are there. As soon as they are asleep, you can leave.

Procedure

  • The surgeon makes a small cut (2-3cm) at the base of your child's belly button, and pushes the fatty lump or loop of bowel back into the abdomen, where it belongs.
  • Muscle layers are stitched over the weak spot in the wall of the abdomen, to strengthen it.
  • The wound on the surface of the skin is closed with dissolvable stitches or special glue. Sometimes, a pressure dressing is applied, which stays on for four to five days.

The whole operation takes 20-30 minutes, but your child will be away from the ward for around one hour. Your nurse will take you to the recovery room as soon as your child wakes up, so you can be with them on their way back to the ward.

Your child will not feel any pain while their hernia is being repaired by the surgeon.

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Page last reviewed: 13/07/2011

Umbilical hernia repair is a small and successful operation. Complications are very uncommon.

Possible risks are:

  • the wound becoming infected and needing antibiotics (this happens in one in 100 cases),
  • the loop of bowel becoming trapped (strangulated), which would mean removing that section of bowel and rejoining the ends, and
  • the hernia returning (a very small risk).

Sometimes, if the hernia has been large, some excess skin remains after the operation, but this will usually settle as your child grows up.

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Page last reviewed: 13/07/2011

Your child will not feel any pain while their hernia is being repaired, but may feel sore and uncomfortable for a few days afterwards. Local anaesthetic (which numbs the area) will be injected before the end of the operation to reduce the pain. Painkillers will also be given after the operation.

After the operation, your child may be tearful and sleepy, and demand extra attention as a result of the anaesthetic. This is quite normal and will pass.

Most children will be able to go home a few hours after surgery. They must first have something to eat and drink, and go to the toilet. Your child may need to stay in hospital overnight if:

  • they have other medical problems, or
  • they vomit regularly after the operation and cannot keep down any food or drink.

At home

Your child may have bruising and tenderness around the wound. This is normal and will settle within around seven days. You can give them painkillers such as paracetamol and ibuprofen (children under 16 must not be given aspirin).

Try to keep the wound dry for five to seven days. Your child can have a shower but they should avoid swimming and bathing.

Most children naturally limit their own activity for a few days until they feel comfortable and well.

Going back to school

You can keep your child off school for five to seven days. This will give them time to recover from the anaesthetic and from the operation.

If your child is older, ask for them to be excused from sports and games for at least two weeks after returning to school.

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Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

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