Umbilical or para-umbilical hernias are relatively common in adults. The main predisposing factors are overweight and pregnancy. As they tend to get bigger over time, it is highly recommended to have them surgically repaired.
If hernia repair is delayed or not performed there is a medium risk that some abdominal contents, usually intestine or a bit of fat, can get stuck (incarcerated) in the hernia defect.It gets swollen due to venous stasis and oedema,and tends to be impossible to push back in.This condition is usually very painful. If the blood supply is compromised (strangulation), urgent surgery is needed to prevent irreversible damage of the affected tissues.

Incarcerated abdominal tissue may cause nausea, vomiting, and abdominal distension.
In elective cases the surgery is optimally perfomed under general anesthesia, but small hernias may be repaired while the person is under local anesthesia. A surgical cut is usually made under the belly button. The surgeon step-by step identifies the hernia sac, separates it from the surrounding tissues, and pushes it back inside the abdominal cavity.

Smaller defects may be closed with strong non-absorbable sutures (stitches).
In case of a larger defect, or a too weak abdominal wall, it is impossible to close it without tension. Tension is one of the leading causes of reoccurrence. To avoid tension, these larger defects should be closed with a piece of plastic tissue friendly mesh placed above the peritoneum.
The long-term prognosis is excellent. Very rarely the hernia may come back. Recurrence is more common if larger hernias are repaired without a mesh. In such case it should be redone using a mesh.

Post operative care and recovery
Most umbilical hernia repairs are done in day surgery, but in case of larger hernias it may be necessary to stay in hospital overnight. Rarely a vacuum suction drainage may be necessary to introduse during operation, to protect the mesh from haematoma or seroma. These thin tubes are usually removed on the second day after the operation.

Right after surgery and anesthesia you will be monitored in the recovery area for a short period of time, then you will be carried back to the surgery unit.

You will be taught how to take care of your surgical cut in your hotel. If your cut is closed with non absorbable stitches, those will be removed in 8 days. Full activity can be resumed in 2-4 weeks. During these recovery weeks you are not supposed to lift or carry any weights weighing more than a kilo.

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