What are umbilical and paraumbilical hernias?
These hernias are lumps located near your belly button (umbilicus) which often cause pain and discomfort. Umbilical hernias are more common in children, while paraumbilical hernias (around umbilicus) are more common in adults.
How should I prepare for umbilical or paraumbilical hernia repair surgery?
Medication / supplements
You need make the surgical team aware of any medication (including alternative / complementary medicines) or diet supplements you are taking before the procedure.
Smoking
If you are a smoker, you must give up smoking 14-21 days before the procedure.
Diet
You do not need to make any changes to your diet ahead of surgery.
Exercise
Do not do any exercise that causes any pain in the area of the hernia. Otherwise you can continue with any other regular exercise regime.
Avoiding wound infection
You should avoid waxing or shaving in the area where incisions are likely to be made during surgery (your doctor or surgeon will be able to tell you where the incisions will be made). This minimises the risk of wound infection.
Hygiene
There are no specific hygiene requirements before surgery, however you should have a shower or take a bath either the night before or on the morning of the surgery.
Risks / complications
There are risks associated with all surgical procedures, such as wound infection, and risks relating to anaesthesia and bleeding during the procedure.
The risks / complications specific to surgery to correct a umbilical or para umbilical hernia include:
- Haematoma
- Bleeding
- Removal of umbilicus
Dr Silverman will be able to discuss any possible risks or complications with you well ahead of the procedure.
What is involved in the procedure?
This procedure generally takes around half an hour to complete and is conducted under general anaesthesia. Surgery involves a small incision either on (umbilical) or near (paraumbilical) the belly button and any tissue that is protruding (called the 'hernial sac') is pushed back inside the abdominal cavity.
Medical grade synthetic mesh is used to repair the weak part of the abdominal muscle wall. A drain is generally inserted into the incision at this point to allow any fluid in the wound to drain away. The drain is normally removed within 24-48 hours of surgery.
Recovery Guidance
Hospital stay
Most patients undergoing this procedure return home on the same day.
After the procedure you will still be affected by the anaesthetic. This may temporarily cause the following symptoms:
- Dizziness.
- Blurred vision.
- Short term memory loss.
- Nausea.
- Vomiting.
- Sore throat.
- Pain.
This is why it is very important that you do not, during the 24-hour period after the procedure:
- Drive (you must have someone available to drive you home after the procedure).
- Operate dangerous machinery.
- Drink any alcohol.
- Sign any legal documents.
- Make any important decisions.
Pain management
There is often moderate to severe pain after this procedure. There may be some pain once the effects of the local anaesthetic have worn off around two hours after the procedure.
If this is the case we recommend the following combination of Panadol and Ibuprofen for the initial 48-hour period after surgery:
- Two (500mg) Paracetamol tablets every four to six (4-6) hours.
- Two (200mg) Ibuprofen tablets every six to eight (6-8) hours.
If pain continues beyond this period, or if it becomes severe, you should contact your doctor.
In rare cases, this pain relief may not be sufficient – in which case you will need to take stronger pain relief. You will require a prescription for Panadeine Forte – two (500mg) tablets every six to eight (6-8) hours.
Two things to be aware of with pain medication – firstly ensure that you can take medicine containing ibuprofen, such as Nurofen (if you do not know you should check with your doctor) and secondly be aware that Panadeine Forte will make you drowsy and cause constipation.
Wound management
A pressure dressing will be applied to the incision, which must stay in place until the following morning. This is to prevent bruising. A waterproof dressing in place underneath the pressure dressing must stay in place for five days. You are able to shower with this waterproof dressing on. If any fluid or blood collects underneath the waterproof dressing, it may be replaced with another one (these are sold in pharmacies).
Returning to normal activity
The following is general information, although it is a good idea to be guided by any pain during specific activities and ease off if pain continues. Hernia recurrence may result if physical activity is taken up too soon.
5-7 Days After Surgery
General activities, including work (light duties) can be commenced at this point. You should not drive until this point.
14-21 Days After Surgery
Sport and general exercise can be resumed at this point (after laparoscopic surgery). Support stockings can be removed at the 14-day mark.
28 Days After Surgery
At this point you should have a follow up appointment with Dr Silverman.
35-42 Days After Surgery
Sport and general exercise can be resumed at this point (after open surgery).
When to contact Dr Silverman
It is important to look out for any signs of infection of the wound. These might be:
- Swelling.
- Redness.
- Pain.
If any of these occur you should contact Dr Silverman.
Note: it is normal however to be able to feel a hard lump underneath and / or surrounding the belly button in the weeks after surgery.