What is an umbilical hernia?

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An umbilical hernia, also commonly termed a "belly button" or "navel" hernia, is a defect (hole) that develops in the muscle and tissues of the abdominal wall which allows abdominal contents such as the small intestine, colon, or fat to protrude through the defect.  Most umbilical hernias are congenital and present since birth but become larger and cause symptoms later in life.  Patients with an umbilical hernia usually develop a bulge in the belly button area that is often initially asymptomatic but over time becomes symptomatic.  The most common symptoms of an umbilical hernia are bulging, pressure, burning, and pain.  Factors that can cause a hernia to worsen or develop are weight gain, excessive straining, chronic coughing or sneezing, pregnancy, and heavy lifting.  While most umbilical hernias are not dangerous, they will never resolve without surgery.  If left untreated, umbilical hernias can become incarcerated or strangulated — when tissues or intestine become trapped in the hernia and their blood flow is compromised.  An incarcerated or strangulated umbilical hernia can be a life threatening condition that often requires emergency surgery.  To resolve patient symptoms and prevent incarceration/strangulation, most surgeons recommend surgical repair for all healthy patients that have a symptomatic umbilical hernia.

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How is an umbilical hernia repair performed?

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The traditional technique for repairing an umbilical hernia for over a century was to make an incision in the umbilical area and use sutures to close the hernia defect.  These hernia repairs were under tension and had high recurrence rates, causing many patients to undergo redo surgeries.  In the early 1960s, synthetic mesh began to be used to perform open umbilical hernia repairs that were tension free and had lower recurrence rates.  From the 1960s to the present day, continual improvements in surgical techniques and synthetic mesh linings have made open umbilical hernia repairs the standard.

A select number of patients with large, complicated, or recurrent hernias are candidates for a robotic assisted laparoscopic umbilical hernia repair.  Using small incisions, a video camera and thin instruments are used to secure a mesh beneath the defect to repair the hernia.  Dr. Mueller routinely performs robotic assisted laparoscopic umbilical hernia repairs for a select group of patients.