Patient Information Sheet
Epigastric and Umbilical Hernia Repair
What is an Umbilical or Epigastric Hernia?
An umbilical or epigastric hernia occurs when tissue, such as part of the intestine or fat, pushes through a weak spot near the belly button/umbilicus or through a defect in the abdominal wall. It may appear overtime or come on following an acute event.
It may appear as a lump or swelling near the belly button.
It can become more noticeable when coughing, straining, or standing up.
In some cases, it may cause discomfort or pain. Rarely it can become stuck and strangulate necessitating emergency surgery.
Why is Surgery Needed?
Umbilical hernias do not usually go away on their own in adults. Surgery is recommended because:
The hernia may get larger over time.
There is a risk of bowel or fat getting trapped (incarceration) or blood supply being cut off (strangulation), which is an emergency.
Repair relieves symptoms and prevents complications.
However, one may elect to leave the hernia alone and this is a perfectly reasonable course of action. We will discuss the individual risks and benefits as they relate to you in clinic.
The Operation
Surgery is performed under a general anaesthetic, usually as a daycase. The hernia is repaired through a small cut near the belly button or directly above the lump for an epigastric hernia.
The hernia is repaired with either just some non-dissolvable stiches or in combination with a piece of inert mesh to reinforce the defect. The size of the defect will become apparent during surgery, and this will determine whether mesh is required.
The operation usually takes between 30-60 minutes to perform. Immediately following surgery you will spend a short period of time in the theatre recovery room before going back to your room on the ward. Once there the nurses will observe you for a few hours before deciding that you are fit for discharge home.
Risks and Possible Complications
As with all operations, there are some risks, though serious problems are uncommon:
Pain, swelling, or bruising around the wound.
Infection at the wound site.
Bleeding or fluid collection, sometimes called a seroma.
Recurrence of the hernia (hernia coming back), approximately 1-2% risk.
Reaction to anaesthesia.
Rare risk of damage to surrounding structures.
There is the rare possibility of developing a deep vein thrombosis after surgery, so early mobility is important.
If you experience any issues or concerns during the post-operative period, please contact the hospital you had your surgery at on the contact number provided to you on your discharge. Alternatively, my secretary can be contacted by email (secretary@sussexsurgeon.com) or phone 07963 466976. Her working hours are between 09:00 to 16:30 Monday to Friday, except Wednesday.
After the Operation
You are free, and encouraged to do so, to walk as far as you feel comfortable. The distance you can walk will increase with time. You will be able to walk up and down stairs.
I would advise that you do not drive until you can confidently and safely perform an emergency stop in your car. This is likely to be at around 4-5 days after surgery, but will vary from individual to individual.
I would like you to avoid any strenuous exercise, particularly anything that involves straining or heavy lifting, for 4 weeks. The reason for this is to allow the repair time to become fixed.
I am happy for you to return to work when you feel comfortable to do so, if you have an office-based job. You may want to consider working from home for the first week after surgery. If you have a physical job, I request that you are placed on light duties for the four weeks that follow your surgery. We can provide you with a sick note if required by your employer.
You are fit to fly 5 days following surgery, should you feel able to do so. If you are taking a long-haul flight at that point it would be advisable to wear some TED stockings, ensure you stay hydrated and take the opportunity to get up and walk around at intervals during the flight.
Andrew Day