Umbilical Hernia Repair Los Angeles

Sometimes a baby is born with an umbilical hernia. When this happens, the opening that is in the abdominal wall for the umbilicus doesn’t close thoroughly right after birth. This can appear as a lump or an “outie” navel. This can be corrected with a pediatric hernia repair procedure performed by our expert pediatric hernia specialists.

In adults, too much abdominal pressure can cause an umbilical hernia. It’s a common occurrence for women during pregnancy, for example, when the abdominal wall is stretched to accommodate the growing baby.

Weight gain, fluid in the abdominal cavity, or even repeated strain from coughing can also cause umbilical hernias to form. Sometimes an umbilical hernia will form because of weakness in the abdominal wall after unrelated abdominal surgery.

A congenital weakness in the abdominal wall behind the navel can go completely undetected for years, and then appear as a hernia.

The best umbilical hernia repair for you will depend on the exact nature of your hernia. Umbilical hernias may be simple, such as just a small hole in the abdominal fascia. In this case, our surgeons recommend repairing the umbilical hernia by returning the bowel to its proper location, and then closing the hole in the abdominal wall. In many cases, an underlay mesh is used, which is placed to remove tension from the abdominal wall during closure. This gives the abdominal wall a chance to heal well in a tension-free environment, which is the key to a successful outcome.

Sometimes, patients with an umbilical hernia have an underlying condition called “rectus diastasis” or abdominal muscle separation. This can occur in both men and women, but is especially common after pregnancy. The muscles on either side of your abdomen, the ones that make up your “six pack” are called the rectus muscles. They normally join at your midline, adjacent to your navel. These muscles can separate or stretch apart, called a diastasis. You can tell you have a rectus diastasis because you will notice your abdomen bulges easily after meals, it is difficult to “suck it in”, and your abdominal strength is reduced.

If your umbilical hernia includes rectus diastasis, your abdominal muscles need to be repaired. The separation of the muscles creates a natural weakness of the abdominal wall, so repair of the muscles at the same time as the hernia will decrease the recurrence rate, be a stronger repair, and will increase the strength of your entire core.

Pediatric hernia surgeon Steve Chen recommends that parents keep an eye on their babies with umbilical hernias, to see how they change as the child grows. It’s a defect in the abdominal wall, but it is one that will sometimes resolve without the need for surgery. A umbilical hernia that remains for a year or two should be repaired with elective umbilical hernia surgery, to prevent future complications as the child grows.

In a child, the hernia repair procedure is usually very simple. The hole is closed with sutures, and the abdominal muscles grow back together as the child grows.

You may have heard of a “mesh” hernia repair, or know someone who has gotten one. While surgical mesh is an excellent surgical tool for some types of hernia repairs, our reconstructive surgeons do not recommend them for patients who want to retain and improve their natural physiology.

In an “overlay” mesh repair, surgical mesh is used to cover the hole in the abdominal wall on the outside of the hernia sac, much as you would patch a hole in a tire. Rather than returning your abdominal wall muscle to its natural state, a fix of this type just covers the hole. Future strain or expansion could stretch hole beyond the patch, pulling it loose and causing the hernia to return. In addition, the surgical mesh is a foreign substance to your body, so there is always the danger that it will be rejected by your body or that it will not be able to perform its desired function.

But the main reason to avoid an overlay mesh repair is that it has a high failure rate. Well over 50% of overlay mesh repairs result in a recurrence of the hernia.

In an “underlay” mesh repair, the surgeon uses a laparoscopic procedure to approach the tear in the abdominal wall from behind – it’s as if you were patching that tire from the inside. These patches may hold a bit better than an overlay patch, but they don’t restore your anatomy to its original position, and the failure rate for them is still about 20%, compared to less than 1% in the repairs done by one of our surgeons.