Umbilical hernia: everything you must know: part 2

In the second article of a two-part series, leading colorectal surgeon Mr Daniel Baird discusses the surgical options for umbilical hernias, answers any questions you may have and provides safety tips.

Who gets an umbilical hernia? What are the risk factors?

Umbilical hernias can occur in individuals of all ages, from infants to adults. Here are some factors that may contribute to the development of umbilical hernias and the associated risk factors:

Age: Umbilical hernias can occur at any age. Advancing age is a risk factor.

Pregnancy: Pregnancy is a common risk factor for umbilical hernias. The increased intra-abdominal pressure and stretching of the abdominal muscles during pregnancy can contribute to the development of a hernia.

Obesity: Excess body weight and obesity can strain the abdominal muscles, potentially leading to the development of hernias, including umbilical hernias.

Abdominal surgery: Previous abdominal surgeries, especially those involving the umbilical area, can weaken the abdominal wall and increase the risk of hernias.

Chronic cough or straining: Chronic conditions that lead to persistent coughing, such as chronic obstructive pulmonary disease (COPD), or frequent straining during bowel movements can contribute to the development of hernias.

Connective tissue disorders: Some individuals with connective tissue disorders or collagen disorders may be more prone to hernias due to weakened connective tissues.

It's important to note that while these factors may increase the risk of umbilical hernias, not everyone with these risk factors will develop a hernia. If you have any question about an umbilical hernia make an appointment with me to discuss the issue.

I am having an operative repair, how can I make it as safe and effective as possible?

Preparing for an umbilical hernia repair involves optimising your overall health to ensure a smoother surgical experience and better postoperative recovery. Here is some advice to help you prepare for umbilical hernia repair:

Smoking cessation: Smoking does impair healing and increase the risk of complications. If you smoke, you should stop or at least reducing your smoking 8 weeks before and 8 weeks after surgery.

Weight management: An ideal weight is BMI 18.5-25. If you are overweight (BMI above 25), losing weight before surgery will reduce the risk of complications and improve recovery. Being outside the recommended BMI range  is not prohibitive for surgery. Crash diets and starvation states are unhealthy and could also negatively affect outcome. If you would like to calculate your BMI there are online calculators, you just need your own height and weight.

Healthy diet: It is important that you maintain a well-balanced diet, full of I fruits, vegetables, lean proteins, and whole grains. Adequate nutrition is crucial for the healing process. Consider increasing your intake of fibre to prevent constipation.

Regular exercise: Engage in regular, moderate exercise to improve your cardiovascular fitness and overall health. Low impact cardiovascular exercise such as swimming is recommended prior to a repair.

Diabetes: For diabetic patients good sugar (glycaemic) control is ideal as this will help healing.

Hydration: Stay well-hydrated in the days leading up to surgery. Adequate hydration supports general health and can aid in recovery.

Prepare your home: Arrange your living space to facilitate a comfortable recovery. Consider items such as loose-fitting clothing, extra pillows, and a designated area for rest.

Plan for assistance: Arrange for someone to assist you during the initial days of recovery, as you may need support with daily activities.

Understand the procedure: Have an understanding of the surgical procedure, expected recovery time, and potential complications. This information will help to mentally prepare you and set realistic expectations.

Each person's situation is unique, and I will provide personalised guidance based on your health status and the specifics of your hernia.

Is mesh safe in umbilical hernia repair?

Not all hernias require a mesh. The use of mesh in an umbilical hernia repair is a common and widely accepted practice. Mesh provides additional support to reinforce the weakened abdominal wall, reducing the risk of hernia recurrence. The safety and efficacy of mesh in hernia repair have been well-established through extensive clinical research and years of medical practice.

Here are some key points regarding the safety of mesh in umbilical hernia repair:

Reduced recurrence rates: The use of mesh has lowered the recurrence rates of umbilical hernias compared to traditional tissue-based repairs without mesh. Mesh provides additional strength and support to the repaired area, reducing the likelihood of the hernia recurring.

Mesh types: There are different types of mesh materials used in hernia repair, including synthetic meshes and biological meshes. Synthetic meshes are often made from materials like polypropylene, while biological meshes may be derived from animal tissues. The choice of mesh type may depend on various factors, including the patient's health and the specifics of the hernia.

Complications and considerations: Mesh is considered safe and its use is a standard practise however, there can be a downside. The risk of mesh infection is reduced with prophylactic antibiotic on the day of surgery. It is rare but if it occurs it is treated with prolonged course of antibiotics and can require mesh removal. Chronic pain is a potential complication of mesh, but advancements in surgical techniques and mesh materials have aimed to minimise this risk. A patient experiencing life-altering pain over a year is extremely unlikely. Other mesh related issues, such as mesh migration or contraction, are uncommon but can occur.

Non-mesh repair: A patient may have a non-mesh repair if the hernia is small. The recurrence rate is expected to be higher compared to a mesh repair and it is not my usual recommendation if the defect is one centimetre or more.

It's important to note that complications associated with mesh are rare, and the benefits, including lower recurrence rates, often outweigh the risks. If you have specific concerns or questions about the use of mesh in your hernia repair, you must discuss them with me. I can provide you with the bespoke information for your individual situation.

If you suspect you have a umbilical hernia and would like to book a consultation with Mr Baird, simply visit his Top Doctors profile today.