Tests and treatments

Umbilical hernia repair

What is it?

What is it?

Umbilical herniae smaller than one centimetre can simply be repaired with a few stitches. Larger hernias are best reinforced with a prosthesis or 'mesh'.

This prosthesis may be placed through open surgery or through keyhole surgery.

Types of treatment

For larger umbilical herniae, incisional herniae after a laparoscopy or recurrent umbilical herniae, we usually opt for laparoscopic hernia repair (keyhole surgery) at the Maria Middelares Hernia Centre in Ghent. However, sometimes there are good reasons to perform the surgery in the classical way and in that case, the surgeon will discuss this with you in the pre-operative consultation.

Keyhole surgery for umbilical hernia repair allows for the placement of a large prosthesis. It is important for the prosthesis to be properly fastened to the abdominal wall with 'staples'. These staples will secure the prosthesis to the abdominal muscles. This may be quite painful in the initial post-operative period, especially when sneezing or coughing as this causes the muscles to contract. It is therefore important to take good pain relief the first few days after laparoscopic umbilical hernia repair.

For a laparoscopic hernia repair, a prosthesis is used that is soft on one side to prevent fusion with the intestines. If you wish, your surgeon can show you the mesh during the pre-operative consultation.

In September 2016, the Maria Middelares Hernia Centre in Ghent became the first European centre to offer robot-assisted laparoscopic hernia repair. This was initiated after extensive training in the United States. The procedure is essentially the same as traditional laparoscopy. The difference lies in the fact that the surgeon operates the instruments and camera from a console. At the Maria Middelares Hernia Centre in Ghent, we use the latest generation of the Intuitive DaVinci Xi robot. Dr Muysoms now trains European surgeons. Together with other surgeons performing robot-assisted umbilical hernia repair, an innovative technique was developed at the Hernia Centre in Ghent. The prosthesis is placed not in the abdomen, but between the various muscle layers. This new technique, termed TARUP (trans abdominal retromuscular umbilical prosthesis), retains the advantages of keyhole surgery. The technique also avoids placing the prosthesis so that it comes into contact with the bowels and avoids painful fastening of the prosthesis using staples.

At the Maria Middelares Hernia Centre in Ghent, we usually opt for ‘open’ surgery. This is done directly through the navel for herniae whose diameter measure under two centimetres.

For an open umbilical hernia repair procedure, we generally use a round umbilical hernia prosthesis that is placed beneath the abdominal muscles through the navel. For this procedure, the maximum size of the mesh is 8.4 cm in diameter. As most meshes will shrink a little over time, such a Ventral Patch is not recommended for herniae of more than two centimetres.

A laparoscopic procedure will be proposed for larger herniae.

Possible complications

Possible complications

Umbilical hernia surgery generally is a safe procedure and serious complications are rare. Possible complications are listed below. The list is not exhaustive but contains the most frequent complications:

Bruises, wound infection and wounds opening up.Change from keyhole surgery to an open procedure.
Bleeding of the abdominal wall or navel; this sometimes requires another operation.Complications that are not directly caused by the surgery: pneumonia, bladder infection, heart rhythm disorders, etcetera
Infection of the prosthesis.Complications associated with general or epidural anaesthesia.
Accidental injury of the bowel or other abdominal organ.Over the long term, the surgical site will remain painful for some patients.


Some side effects occur very frequently but are no reason for concern:

After the operation, a swelling often remains for a few weeks where the umbilical hernia was located. This is fluid accumulation (also termed seroma) that usually is not painful but often causes patients concern. This swelling is a normal side effect of the operation. It will slowly disappear of its own accord. If, in exceptional cases, the fluid accumulation causes pain, the surgeon may decide to drain it.

Another common side effect is bruising around the wounds. This is no cause for concern either, and it will spontaneously disappear in the weeks following the operation. In case of doubt or concern, feel free to contact your GP or our department.

Can an umbilical hernia recur?

A mesh placement reduces the risk of a recurrent umbilical hernia. Yet it is not always avoidable. This is because the mesh may shrink a little, causing the weakened area in the abdominal wall to expand. This means that approximately 10% of patients will develop a new umbilical hernia in the area around the navel. These are often small and do not require a second procedure. However, if a new umbilical hernia becomes bigger and/or is painful, a new repair is required with a bigger prosthesis. About 1 in 20 patients (5%) will need to undergo a second procedure within the ten-year period after the umbilical hernia repair.

Aftercare

Aftercare

Umbilical hernia operations can be performed in the day clinic for most patients. If necessary, admission for one night will be arranged.

It is important that you are active and move around a lot as soon as possible after the operation.

To be avoided for three weeks:

  • lifting heavy loads
  • intensive sports practice.

You will also be given a bellyband that you may wear in the first weeks for support. After the check-up with the surgeon, three weeks after the operation, you will be able to resume all activities, including lifting and sports.

After discharge from hospital:

  • Visit your GP ten days after surgery for a check-up of your wound and to have sutures removed. In case of problems, you (or your GP) can of course always contact our department.

How much does an umbilical hernia repair cost?

How much does an umbilical hernia repair cost?

The Maria Middelares Hernia Centre in Ghent charges the official RIZIV prices. In addition to the surgeon's and anaesthesiologist's fee, this will display the general charges for hospital admission and the use of materials such as the mesh. A supplement to the fees will also be charged if a single room is chosen.

Perform a cost estimate at the bottom of the page.

Cost estimate

Cost estimate
This information is not available at the moment, please contact facturatie@mijnziekenhuis.be to make this estimate.

Centres and specialist areas

Centres and specialist areas

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Latest publication date: 13/08/2024