Umbilical hernia
Umbilical hernia surgery in San Pedro Sula
Why it does not close on its own in adults, when repair makes sense, and the role of mesh.
01 — What it is
Umbilical hernia: the navel that pushed out
An umbilical hernia is a defect in the abdominal wall at or around the navel. It is common in adults and is usually noticed as a navel that "popped out" or a bulge that appears when coughing, lifting or straining.
In adults it does not close on its own. Unlike the umbilical hernia of a newborn — which often resolves spontaneously — the adult form is an acquired defect that tends to enlarge over time.
- Typical symptomsA bulge at or beside the navel, more visible when standing or straining, which may reduce when lying down.
- DiscomfortLocalised pain or a dragging sensation, particularly when lifting or coughing.
- Contributing factorsSustained increases in abdominal pressure: obesity, pregnancies, chronic cough, constipation, repeated physical effort.
- Warning signA bulge that becomes hard, red or very painful and no longer reduces, with nausea or vomiting. That is an emergency: seek care immediately.
02 — When to operate
Does every umbilical hernia need surgery?
Symptomatic umbilical hernias are repaired. The reason is twofold: they do not resolve spontaneously, and small defects carry a relatively higher risk of incarceration because the ring is narrow — a small hernia is not necessarily a benign hernia.
In asymptomatic hernias the decision is individualised according to defect size, symptoms, the patient's surgical risk and associated conditions. That analysis happens in consultation, with your case in front of us.
Clinical basis: The joint guidelines of the European Hernia Society and the Americas Hernia Society recommend that symptomatic umbilical and epigastric hernias be repaired, and transparently note that most of their recommendations are weak because the available specific evidence is of low quality.
Henriksen NA, et al. Guidelines for treatment of umbilical and epigastric hernias from the European Hernia Society and Americas Hernia Society. Br J Surg. 2020;107(3):171-190.
03 — Technique and mesh
How it is repaired: approach and use of mesh
The main guideline recommendation is to use mesh, because it reduces recurrence compared with suture-only closure. This applies even to small defects, where closure with stitches alone was traditional and recurrence was higher than acceptable.
- Open approachMost umbilical and epigastric hernias can be repaired through an open approach, placing a flat mesh in the preperitoneal position.
- Laparoscopic approachMay be considered when the defect is large, or when the patient is at higher risk of wound complications.
- What drives the choiceDefect size, body mass index, previous abdominal surgery, skin condition and individual risk of surgical site infection.
Clinical basis: The recommendation to repair with mesh and to prefer an open approach with flat preperitoneal mesh for most cases, reserving laparoscopy for large defects or increased risk of wound morbidity, comes from the first joint European and American guideline on umbilical and epigastric hernia.
Henriksen NA, et al. Guidelines for treatment of umbilical and epigastric hernias from the European Hernia Society and Americas Hernia Society. Br J Surg. 2020;107(3):171-190.
04 — Recovery
After surgery
Umbilical hernia repair is usually a day-surgery or short-stay procedure. Recovery is progressive and effort restrictions are temporary.
No figures for days off work are published here because they depend on defect size, technique and each patient's type of work. That estimate is given in consultation, before surgery.