What is an umbilical hernia?
- An umbilical hernia is a protrusion of the belly button (umbilicus) due to lack of closure of the abdominal wall during embryologic development. The opening in the abdominal wall allows the intestine to enter causing a visible “bulge” in the abdomen. Umbilical hernias, in children, are often present at birth and can either be large or unnoticeable until later in life. Umbilical hernias can close on their own over the first 4-5 years of life and this is more likely for smaller hernias than for larger ones. Surgery is often delayed until age 4 or later because there is a chance the hernia can close on it’s own, the child’s tissue gain more strength by age 4, and serious complications are unusual with these types of hernias. The size of the hernia will determine the likelihood of spontaneous closure. Hernias that have a defect in the muscle one inch or larger are unlikely to heal on their own. Hernia defects less than ½ inch have a 90% or greater chance of healing on their own. The other umbilical hernias that are unlikely to heal are the ones with large protuberant skin. Umbilical hernias may become more prominent when the child is laughing, crying, straining, lifting or having a bowel movement.
- Umbilical hernias are usually painless and are diagnosed based upon history and physical examination by a physician.
- Premature infants and African Americans have an increased risk of developing an umbilical hernia.
What will happen in the hospital?
- Your child will come to the hospital for surgical repair of the umbilical hernia. This is outpatient surgery, meaning your child will be discharged the same day.
- This surgery is with the child completely asleep under general anesthesia. A small incision is made at the base of the belly button and the defect, or opening, is repaired with sutures. The skin is closed using absorbable sutures so he/she will not have to have any sutures removed. The sutures will dissolve on their own over several weeks. Either a small, white, steri strips is placed over the incisions or the repair site is covered with gauze and tegaderm. Occasionally umbilical hernias with very protuberant skin may need removal of the redundant skin to improve the postoperative appearance. The dressing remains in place as directed by your surgeon.
When will my child be discharged?
- Your child will remain in recovery for a few hours. He/she can be discharged once he/she can drink fluids and the pain is under control.
What will be my child's recovery?
- Recovery usually lasts a day or two, depending on the age of the child. Younger children are able to resume normal activities very quickly, while older children take a few days before feeling back to themselves.
- Your child may take a shower, but cannot swim or bathe for 7-10 days after surgery.
- We also advise against heavy lifting, sports, or exercise for 2 weeks
- Your child may resume school two days postoperatively
- There are no dietary restrictions
What should I be looking out for after the operation?
- Monitor for fevers
- Monitor for signs of infection such as redness, swelling, drainage or foul smell from wound
- Monitor for pain
- There is a small chance of recurrence (<1 percent)
- Occasionally some children develop a stitch abscess. This is observed by seeing one of the sutures sticking out of the belly button. In this case the suture will continue to fall off on its own in a few days to weeks later or it can be removed in clinic using a tweezer.