Umbilical Hernias

Umbilical Hernias – Omphalocele
Umbilical hernias are the second most common hernias of the abdominal wall after inguinal hernias. An umbilical hernia of a newborn baby, however, is the exception to the rule. Infantile umbilical hernias rarely lead to an incarceration and can thus be described as the only hernias that heal spontaneously: 98 % of all hernias diminish within the space of 2 years.

Once the child has passed the age of two, all umbilical hernias should be surgically removed, because every fourth hernia that is not operated on leads to an incarceration within the following years. An umbilical hernia which includes the incarceration of parts of the intestine poses a life threatening situation to the patient even today in this day and age.

If the contents of the hernial sac are jammed (rarely occurs) and it is not possible to push it back into the abdominal cavity, an operation needs to be carried out immediately without any delays. The patient will suffer severe pain, nausea and vomiting in such a situation.

Surgical Procedure
The operation involves either closing the gap located at the navel or the abdominal centre line which was caused by the rupture. It is quite possible that over the years small parts of the peritoneum have grown into the gap created by the rupture. The gap usually has a diameter of less than 2 cm and will be sutured shut provided the patient is slender and young.

The abdominal wall should be strengthened with a synthetic net, if a larger defect is at hand, in order to reduce the risk of a relapse. Thus we use a polypropylene net to conduct the onlay-technique or more commonly a net that features 2 different sides to carry out the inlay-technique. One of the sides of the net possesses a special coating, which prevents further growths between net and the contents of the abdomen. For these reasons the coated side is inserted into the abdomen first.

Aftercare
Immediately after surgery the patient will be able to conduct normal day-to-day activities (such as clothing him/herself, personal hygiene, walking). Eating and drinking are also possible straight away. A patient will be able to resume normal physical activities, such as household chores, easy work in the garden, cycling and driving a car, once the wound has healed at the latest (approx. 10-14 days). More difficult or serious physical activities may be taken up again approx. 2-4 weeks after surgery, if the patient feels capable of doing so.