Umbilical hernia repair

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.

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.