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introduction
signs and symptoms
surgery
surgical option
recovery

How long does it take to recover after a paraumbilical hernia repair?

You can have this repaired as a day case or as an overnight stay.  Recovery is usually about 7 days for most patients.  Your ability to drive a car is governed by being able to put your right foot on the brake pedal to perform an emergency stop without inhibition (automatic transmissions) or both feet on the clutch and brake pedals (manual transmissions).  Avoidance of heavy lifting or straining for three months is recommended to allow the tissues to reach their maximal tensile strength and therefore reduce the risk of recurrence.

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If you need any advice or help with hernia-related conditions, feel free to contact us.

References

  1. Lichtenstein IL, Shulman AG, Parviz KA, Montllor MM.  The tension-free hernioplasty.  American Journal of Surgery 1989; 157: 188-193

  2. Conceptualization and measurement of physiological health for adults.  Santa Monica, CA: Rand, 1983: 3-120

  3. Welsh DRJ, Alexander MAJ.  The Shouldice repair.  Surgical Clinics of North America 1993; 73:451-469

  4. Juul P, Christensen K.  Randomized clinical trial of laparoscopic versus open inguinal hernia repair.  British Journal of Surgery 1997; 84: 64-67.

  5. Fleming WR, Elliott TB, Jones R McL, Hardy KJ.  Randomized clinical trial comparing totally extraperitoneal inguinal hernia repair with the Shouldice technique.  British Journal of Surgery 2001; 88: 1183-1188.

  6. The MRC Laparoscopic Groin Hernia Trial Group.  Laparoscopic versus open repair of groin hernia: a randomized comparison.  Lancet 1999; 354: 185-190.

  7. Liem MSL, van der Graaf Y, Steensel CJ et al.  Comparison of conventional anterior surgery and laparoscopic surgery for inguinal hernia repair.  New England Journal of Medicine  1997; 336: 1541-1547.

  8. Kumar S, Nixon SJ, MacIntyre IMC.  Laparoscopic or Lichtenstein repair for recurrent inguinal hernia: one unit’s experience.  Royal College of Surgeons of Edinburgh 1999; 44: 301-302.

  9. Memon MA, Cooper NJ, Memon B, et al.  Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. British Journal of Surgery 2003; 90: 1479-1492.

  10. Callesen T, Bech K, Kehlet H.  Prospective study of chronic pain after groin hernia repair.  British Journal of Surgery 1999; 86: 1528-1532.

  11. Hindmarsh AC, Cheong E, Lewis MPN, Rhodes M.  Attendance at a pain clinic with severe chronic pain after open and laparoscopic inguinal hernia repairs. British Journal of Surgery 2003; 90: 1152-1154.

  12. Poobalan AS, Bruce J, King PM et al.  Chronic pain and quality of life following open inguinal hernia repair.  British Journal of Surgery 2001; 88: 1122-1126.

  13. Knook MTT, Weidema WF, Stassen LPS, Boelhouwer RU, van Steensel CJ.  Endoscopic totally extraperitoneal repair of bilateral inguinal hernia.  British Journal of Surgery 1999; 86: 1312-1316.

  14. EU Hernia Trialists Collaboration.  Laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials. .  British Journal of Surgery 2000; 87: 860-867.

  15. Arroyo A, Garcia P, Perez F, et al.  Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults. British Journal of Surgery 2001; 88: 1321-1323.

  16. Macleod DAD, Gibbon WW.  The sportsman’s groin. . British Journal of Surgery 1999; 86: 849-850

  17. Ingoldby CJH. Laparoscopic and conventional repair of groin disruption in sportsmen. . British Journal of Surgery 1997; 84: 213-215.

Paraumbilical Hernia

Introduction

What symptoms and signs do paraumbilical hernias cause?

Do paraumbilical hernias need surgery?

What are the surgical options?

How long does it take to recover after a paraumbilical hernia repair?

Introduction

Paraumbilical hernias occur in all age groups and must be distinguished from umbilical hernias as they do not resolve spontaneously. Paraumbilical hernias are more common after the age of 35 years and are five times more common in women than men.   These hernias arise because of weaknesses which develop in fibrous tissue above and below the umbilicus in the midline and in the fibrous tissue around the umbilicus.  The commonest site is in the midline just above the umbilicus.

What symptoms and signs do paraumbilical hernias cause?

There may be a swelling just above the fold of the umbilicus which is more noticeable when the patient coughs or strains.  Pain (possibly caused by dragging on the fat and peritoneum of the supporting ligament on the inside of the abdominal cavity in the midline) may also be present.  They are often tender to touch.  If the hernia is small, the diagnosis is aided as the patient stands erect and your specialist palpating the midline to the umbilicus.  The paraumbilical hernia may be felt as a small palpable nodule, just above or below the umbilicus.  Localised severe pain, redness, tenderness and general poor well being may indicate strangulation or inflammation.

Do paraumbilical hernias need surgery?

Yes: as the incidence of complications, such as incarceration, inflammation and necrosis, is much higher than for true umbilical hernias.

What are the surgical / treatment options?

They can be easily dealt with by open surgery through a small incision, above or below the umbilicus.  The defect is best repaired using a tension free mesh technique placed in the preperitoneal plane so that the mesh does not stick to the intestines.  A recent study has shown that the mesh repair is superior in terms of reducing the recurrence rate and where the minor complications were similar in both mesh and sutured groups15.  Although this study was carried out for umbilical hernias, the principle is the same.

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