Umbilical Hernia Surgery for Children

Overview

What is umbilical hernia surgery?

Umbilical hernia surgery is a procedure to repair a hernia in a child’s abdominal (belly) area.

The procedure is typically short (around an hour) and successful. Children often return to their regular activities within a few days.

What is an umbilical hernia?

An umbilical hernia is an unusual bulge that you can often see or feel over the belly button (the umbilicus). An umbilical hernia develops when part of the intestine, together with fat or fluid, forms a sac. This sac pushes through an opening in the muscle of the abdominal wall. Usually, hernias do not cause pain in children.

Umbilical hernia.

Why do children get umbilical hernias?

Sometimes, a child is born with an opening in the abdominal wall. This problem happens as the baby develops during pregnancy — the abdominal wall muscles don’t fully close around the organs.

A hernia happens when the intestine starts to push through the opening. You may see the bulge in the belly button all the time. Or you may only notice it when your child is straining those muscles in some way — either by crying, coughing or straining while pooping.

How common are umbilical hernias?

Umbilical hernias occur in 1 out of 6 children. They affect boys and girls equally. They’re more common in babies born prematurely.

Does an umbilical hernia need treatment?

An umbilical hernia may not need any treatment. If it does, surgery can repair it.

Most of the time — in more than 90% of cases — umbilical hernias heal on their own by the time a child is three or four years old. Your healthcare provider will likely recommend waiting until that age to do surgery.

Your child is more likely to need surgery if the hernia is:

  • Incarcerated.
  • Larger than two centimeters, around ¾ inch.

Larger and incarcerated hernias are less likely to heal on their own and will probably need hernia repair surgery.

What’s an incarcerated hernia?

An incarcerated hernia is more severe. It happens when the intestines get trapped in the muscles and cause pain and tenderness. A healthcare provider needs to examine the hernia to prevent damage to the intestines. The child may be in pain. The bulge is often red and firm.

Procedure Details

How long does umbilical hernia surgery take?

Umbilical hernia repair takes about an hour. It’s usually an outpatient procedure, so you can take your child home the same day as the surgery. Premature infants and children who have other medical conditions may need to spend a night in the hospital so the care team can observe them.

What happens before umbilical hernia surgery?

On the day of the surgery, your child will need to follow a strict diet. Doing so helps reduce the risk of vomiting and aspiration (inhaling fluids) while they’re under anesthesia. Your child’s surgeon will review the exact guidelines with you before the procedure.

What happens during umbilical hernia repair?

Your child will receive general anesthesia. This medication relaxes their muscles and puts them to sleep. They’ll be asleep and not feel any pain during the procedure.

Then the surgeon will:

  • Make a small incision at the bottom of the belly button.
  • Find the hernia sac containing the bulging intestine.
  • Push the intestine back into the right place behind the muscle wall.
  • Remove the remaining hernia sac.
  • Reinforce the muscle wall with stitches to prevent another hernia.
  • Sew the skin around the belly button to the muscle beneath it.

How do I care for my child after umbilical hernia surgery?

Children often feel fine by the evening after surgery or the next morning. They can eat their regular foods as soon as they are ready.

To help them as they recover:

  • Use pain medicine: Your provider may give you prescription pain medicine. Many parents find that their child only needs a few doses of this pain medication. After that, you can use over-the-counter pain relievers to keep your child comfortable.
  • Give them a sponge bath: For the first few days after surgery, use a sponge bath rather than a tub bath. Your provider will let you know when it’s safe for a tub bath.
  • Restrict certain activities: Don’t let them do anything that may damage the procedure site. They should avoid bike riding, jungle gyms, wrestling or organized sports. At the follow-up visit, your provider will let you know when your child can resume those activities.
  • Help prevent constipation: Straining on the toilet can cause pain around the surgical area. Make sure your child drinks plenty of water and eats vegetables, fruits and high-fiber foods. This diet can prevent constipation.

Take care of the wound area as it heals:

  • The incision site should heal in about four to six weeks. During the year after surgery, the area will get softer and continue to fade.
  • Avoid tight, rough or scratchy clothing that can rub against the incision.
  • Protect the skin around the wound from the sun. The new skin can burn easily.

Risks / Benefits

What are the advantages of umbilical hernia repair?

Umbilical hernia surgery has several benefits.

The procedure:

  • Resolves the problem: A hernia repair procedure is the only way to fix a hernia that hasn’t closed on its own.
  • Has quick recovery: Children are often back to regular activities in a few days or a week.
  • Reduces the risk of pain and complications: If a child doesn’t undergo hernia repair surgery, the hernia may start to get bigger and cause pain. It may even become incarcerated (when the intestines are squeezed in the hernia sac). If that happens, your child can experience pain and vomiting, and they may need emergency surgery.

What are the risks of umbilical hernia surgery?

Hernia repair surgery is very safe. There is a low risk of complications. But any surgery comes with risks. Complications of hernia repair include:

  • Infection of the wound.
  • Hematoma, a collection of blood around the hernia site.

Recovery and Outlook

What is the recovery time after umbilical hernia treatment?

Your child will be back to their regular activities within a few days. Some children may take up to two weeks to recover if they had a larger or more complex hernia.

You usually return to your child’s provider for a follow-up appointment around three to four weeks after surgery. The provider examines the surgery site and asks how the recovery is going.

When can my child return to school or day care?

Your provider will help you figure out when it’s safe for your child to go back to school. Providers usually recommend keeping children home for a few days or up to a week. This gives them time to recover from the procedure and regain their strength.

When to Call the Doctor

When should I call my child’s provider after umbilical hernia surgery?

Some minor swelling or discoloration around the surgery site is normal. But call your provider if your child has:

  • Bleeding.
  • Excessive swelling.
  • Fever.
  • Inability to urinate.
  • Increasing pain.
  • Redness.

Additional Details

Will an umbilical hernia come back?

Umbilical hernia repair surgery has high success rates. In rare cases, it may recur (come back). Your child’s provider will discuss treatment options if that happens.

A note from Cleveland Clinic

Umbilical hernia surgery for children is a short, safe procedure that has good results. After umbilical hernia repair, your child will be back to their regular activities within a few days. An umbilical hernia is when part of the intestine pushes through an opening in the abdominal wall. In about 95% of cases, umbilical hernias go away on their own by the time a child is three or four. But sometimes the hernia doesn’t go away or the hernia may be larger and more complex. In these situations, your provider will recommend umbilical hernia surgery. During the procedure, the surgeon pushes the intestine back inside the abdomen. If you notice a bulge around your child’s belly button area, talk to your provider.

Last reviewed by a Cleveland Clinic medical professional on 01/13/2021.

References

  • American College of Surgeons. . Accessed 01/05/2021.Pediatric Umbilical Hernia Repair (https://www.facs.org/~/media/files/education/patient%20ed/ped_umbilical.ashx)
  • NHS. . Accessed 01/05/2021.Umbilical Hernia Repair (https://www.nhs.uk/conditions/umbilical-hernia-repair/)
  • Troullioud Lucas AG, Jaafar S, Mendez MD. . [Updated 2020 Oct 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Accessed 01/05/2021.Pediatric Umbilical Hernia (https://www.ncbi.nlm.nih.gov/books/NBK459294/)

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