An umbilical hernia occurs when part of your intestine bulges through the opening in your abdominal muscles near your bellybutton (navel). Umbilical hernias are common and typically harmless. Umbilical hernias are most common in infants, but they can affect adults as well. In an infant, an umbilical hernia may be especially evident when the infant cries, causing the belly button to protrude. This is a classic sign of an umbilical hernia.
Children's umbilical hernias often close on their own in the first two years of life, though some remain open into the fifth year or longer.
Umbilical hernias that appear during adulthood are more likely to need surgical repair and manifest as a protruding belly button. 10% of adult abdominal hernias are umbilical.
During gestation, the umbilical cord passes through a small opening in the baby's abdominal muscles. The opening normally closes just after birth. If the muscles don't join together completely in the midline of the abdominal wall, an umbilical hernia may appear at birth or later in life. Umbilical Hernias are most commonly seen in premature infants or babies with low birth weights, affecting both genders equally.
In adults, too much abdominal pressure contributes to umbilical hernias and the belly button exhibits a large protrusion. Causes of increased pressure in the abdomen include:
Ascites, or excess fluid in the space between the tissues lining the abdomen & organs
An umbilical hernia creates a soft swelling or bulge near the navel. In babies who have an umbilical hernia, the bulge may be visible only when they cry, cough or strain. Umbilical hernias in children are usually painless, however, if a baby appears in pain, begins to vomit or the hernia begins to discolor, medical attention is necessary. Umbilical hernias that appear during adulthood may cause abdominal discomfort, and follow similar guidelines for surgical intervention.
In addition to inguinal hernias in women that can be misdiagnosed as fibroids, ovarian cysts, or endometriosis, women are also prone to umbilical hernias near the belly button, especially with multiple pregnancies. A hearty laugh accompanied by pain can be a hidden sign of this type of hernia.
Complications of an umbilical hernia are rare, and most often occur when the protruding abdominal tissue becomes trapped (incarcerated) and can no longer be pushed back into the abdominal cavity. This reduces the blood supply to the section of the trapped intestine and can lead to abdominal pain and tissue damage. If the trapped portion of the intestine is completely cut off from the blood supply, it can lead to tissue death.
Infection may spread throughout the abdominal cavity, causing a life-threatening situation. Adults with umbilical hernias are somewhat more likely to experience a blockage of the intestines, than infants. Emergency surgery is typically required to treat these complications.
Most commonly, Umbilical Hernia treatment is with surgery, including open, laparoscopic, and robotic hernia repair, because umbilical hernias cannot heal on their own. Therefore, a treatment plan with Dr. David W. Ford begins with examinations to confirm a diagnosis of an Umbilical Hernia. Dr. Ford will review your medical and surgical history, and perform a physical exam of the abdominal area. If other complexities prevent clear identification, Dr. Ford may order imaging tests of the abdomen to verify signs of an umbilical hernia, including an ultrasound, computed tomography (CT) scan, or a magnetic resonance imaging (MRI) study. Dr. Ford will want to clarify that incarceration or strangulation of the hernia has not occurred and that, in females, cysts, fibroids, endometriosis or other tumors have been eliminated. To determine the best surgical hernia repair method, Dr. David W. Ford considers existing medical history, age, hernia size, abdominal wall anatomy, and unique shape, the patient’s available skin needed for repair, and presence of any infections.
The goal of umbilical hernia surgery (Herniorrhaphy or Hernioplasty with mesh insertion) is two-fold:
The surgery restores the tone and shape of the abdominal wall and normalizes the function of the surrounding organs, such as the intestines and reproductive organs. The intestines will only be cut if they have been damaged. A hernia repair is a common but major surgery with significant risks and potential complications. Larger or recurrent hernias can be extraordinarily complex and require a hernia specialist, such as Dr. David W. Ford to have more knowledge, tools, techniques, and skills to tailor the best operation to your situation.
Dr. David W. Ford employs the 2 main types of surgery for hernias: Open Herniorrhaphy or Robotically-assisted Laparoscopic Herniorrhaphy, both with or without a mesh (Hernioplasty).
As a Board-Certified General Surgeon, Dr. David W. Ford operates with a minimally invasive robotic system to repair Umibilical hernias. This minimally invasive approach only requires one or a few small incisions that doctors use to insert surgical equipment and a camera for viewing.
Robotically-assisted Umbilical Hernia surgery utilizes an advanced robotic platform that is not autonomous but is controlled by the surgeon who is seated in the operating room and operates via the Surgeon Console that controls the Patient Cart’s robotic devices, including various surgical instruments and a camera. The da Vinci Surgical System allows surgeons to perform minimally invasive hernia repairs with clinically supported precision and accuracy. Robotically assisted surgery uses a laparoscope (a thin lighted tube with a camera on the tip) that is inserted through one of several small incisions, made away from where the hernia has occurred. The images gathered from the laparoscope’s camera are magnified, high-definition 3D, which are sent to a monitor that Dr. David W. Ford uses to guide the surgical system during the operation. If needed, the abdomen can be inflated with a harmless gas (carbon dioxide), which creates space to allow the doctor to view the inside of the body.
After the intestines or other tissues have been pushed back in, a surgical mesh material is usually inserted to strengthen the weakened area in the abdominal wall. After the procedure is completed, the small incisions in the abdomen are closed with a stitch or two or with surgical tape. While robotic surgery is preferred for the removal of smaller umbilical hernias or repair of weak areas, it can now also be used to reconstruct the abdominal wall. Dr. David W. Ford’s use of the state-of-the-art da Vinci Surgical System in his robotically assisted Umbilical hernia repair surgeries has allowed him to set an exceedingly high standard of expertise that can combine this method with traditional Open Surgery if required. The surgery may only take 30-45 minutes depending on the situation.
Many robotically-assisted surgical systems are FDA approved and in use today. However, many are specially designed for specific organs, procedures, or conditions, such as lung or pulmonary surgeries or knee and other extremity replacement surgeries. The da Vinci Robotic Surgical System is the premier system specialized in hernia repair surgery. Dr. David W. Ford is not only an expert board-certified surgeon but also certified in the use of this leading-edge technology.
This robotic platform offers Dr. David W. Ford fully wristed instruments and a 3D high-definition camera with 10x magnification. As a result, the repair can be done with more precision, and complex hernias can be fixed with small incisions. Furthermore, the robot does not get tired, and Dr. Ford sits during surgery, so there is less surgeon fatigue. For the patient, this translates into quicker recovery, less pain, and fewer complications. This is the preferred approach for medium to large hernias and many umbilical hernias as it combines the best of open and laparoscopic surgeries. Also, Dr. Ford is more likely to be able to sandwich the mesh between layers of the abdominal wall to keep the mesh from coming into contact with the intestines.
Other benefits of robotic hernia surgery include:
Should robotically-assisted surgical laparoscopic surgery be recommended as part of treatment for your Umbilical hernia repair, Dr. David W. Ford and his team will have the best state-of-the-art technology at their disposal to usher in your recovery.
Da Vinci surgical systems are comprised of three components: surgeon console, patient-side cart, and vision cart.
The patient-side cart is positioned near the patient on the operating table. It is where the instruments used during the operation move in real time in response to your surgeon’s hand movements at the surgeon console.
A camera provides a high-definition, 3D magnified view inside your body. Every hand movement your surgeon makes is translated by the da Vinci system in real time to bend and rotate the instruments with precision.
The vision cart makes communication possible between the components of the system possible, and supports the 3D High Definition vision system.
"The da Vinci Surgical System allows me to make smaller incisions, resulting in reduced risk of infection, minimize scarring, reduce pain, and accelerate recovery time, allowing my patients to return to normal activities more quickly."
The traditional surgical method is employed when the hernia is extremely complex, and is most often used with inguinal or umbilical hernias. A complex hernia repair may require mesh removal, resection of the abdomen, or removal of extraneous skin or fat, and therefore is easier with open surgery.
The open surgery requires that a single 5-10 cm long, open incision be made in the abdomen just above or below the belly button, over the location where the hernia has occurred, and then the intestine or abdominal tissue is pushed back into place.
Synthetic mesh material is placed to reinforce this repair and reduce hernia recurrences, however, sutures to close the hernia may be all that is needed. The skin is usually closed with dissolvable stitches and glue. See below about the surgical mesh.
Hernia repair involves an operation, with overall one of two main approaches:
Post-operative Treatment of Umbilical Hernias will vary due to the repair surgical procedure chosen, the severity of the hernia, its location, and any complexities in either surgery or comorbidities of the patient. Usually, patients go home the same day after umbilical hernia surgery. Abdominal wall hernia repairs may require up to a two-day hospital stay due to the need for internal stitches or other complications. At first, you may need to rest in bed with your upper body raised on pillows, to help you breathe easier and lessen post-surgery hernia pain. Both cold and heat can help lessen some types of post-op pain.
After recovery, you can usually return to work or school within 2 to 3 days. You may be prescribed an Umbilical Hernia Support Belt be worn until the abdominal wall and new skin strengthens. You will not be able to lift anything over 10 pounds, climb, or do strenuous activity for 2 to 6 weeks following surgical repair of an umbilical hernia. Always wash your hands before and after touching near your incision site.
Complications are rare, but numbness, hernia reoccurrence, infection, bleeding, or blot clots from improper healing are the main culprit when or if they occur. Losing weight relieves excess pressure on the abdomen, which can prevent a hernia from developing, improve hernia symptoms, and avoid complications such as strangulation.
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