Umbilical hernia in adults is less common than in children, but still represents a significant health problem. In adults, it accounts for approximately 6-14% of all abdominal hernias. The incidence is higher in women especially after multiple pregnancies and in individuals with overweight or obesity. Umbilical hernia in adults requires attention and often surgical intervention to prevent complications and improve the quality of life of the patient. Rapid diagnosis and proper treatment are key to successful management of this condition.
The main causes of umbilical hernia in adults include:
- Increased intra-abdominal pressure - common reasons include obesity, pregnancy, chronic cough, excessive lifting of heavy objects, chronic constipation, or ascites (accumulation of fluid in the abdominal cavity)
- Weakening of the abdominal wall - this condition may be a result of natural aging, surgical procedures in the abdominal area, or injury
- Genetic predisposition - family history of hernias may increase the risk of umbilical hernia
Symptoms of umbilical hernia in adults may include:
- Visible bulge in the area of the navel - this lump usually enlarges when coughing, sneezing, or physical exertion and may be accompanied by discomfort or pain
- Pain or discomfort - these symptoms may be persistent or intermittent and may worsen with physical activity
- Strangulation of the hernia - in case of strangulation of the hernia, acute severe pain, redness, swelling, and symptoms of intestinal obstruction such as nausea, vomiting, and constipation may occur. Strangulation is an urgent condition requiring immediate medical attention.
Diagnosis of umbilical hernia in adults includes:
- Physical examination, where the doctor examines the patient's abdominal area and by palpation detects the presence and size of the hernia
- Ultrasonography is used to confirm the diagnosis and evaluate the contents of the hernia
- CT or MRI - these imaging methods are indicated in case of inconclusive results of physical examination or suspicion of complications such as strangulation
Treatment of umbilical hernia in adults is usually surgical because spontaneous closure is very unlikely. The main treatment methods include:
- Open hernioplasty - a surgical procedure in which the hernia is repaired by closing the defect of the abdominal wall using sutures or mesh implantation that reinforces the weakened area
- Laparoscopic surgery - a minimally invasive method using small incisions and laparoscopic tools to repair the hernia. This method has a faster recovery time and fewer postoperative complications.
Benefits of IPOM (Intraperitoneal Onlay Mesh):
- Less invasive procedure using laparoscopy
- Shorter recovery time and less postoperative pain
- Lower risk of wound infection
- Better cosmetic results due to smaller incisions
- Suitable for more complicated hernias or recurrences after previous surgeries
Benefits of eTEP:
- Minimally invasive approach using laparoscopy
- The mesh is placed outside the peritoneal cavity, reducing the risk of adhesions and erosion into the intestines
- Better anatomical overview during surgery, reducing the risk of damage to internal organs
- Lower risk of infection and better long-term outcome
- Shorter hospitalization time and faster return to normal activities
Basic information
- The procedure is done under general anesthesia
- After the surgery, it is necessary to keep the surgical wound clean and dry and follow the doctor's instructions regarding dressing and hygiene
- It is recommended to consume light food and replenish an adequate amount of fluids
- Avoid bloating foods and heavy meals that may cause constipation
- The first few days after surgery, rest and minimize physical exertion
- Avoid lifting heavy loads and intense physical activities for approximately 4-6 weeks after the procedure
- Gradually increase your activity level according to the doctor's instructions
- Most patients can return to normal activities and work within 1-2 weeks, depending on the nature of the work and individual recovery
- Full recovery takes approximately 4-6 weeks
- After surgery, patients are advised to maintain a healthy body weight, avoid lifting heavy objects, and treat chronic cough or constipation to prevent hernia recurrence