Umbilical hernias with a small ring diameter (< 1 cms) are more likely to close spontaneously and sooner than those with a larger diameter ( >1.5 ms). The diameter is more important than the length of the protrusion of the umbilical hernia. Thus, unless a complication occurs or the child is above 3 years and the defect is still patent, there is no hurry to surgically repair the hernia. There is NO ROLE for a coin, belt or truss over the umbilical defect to enhance the closure ? this is very dangerous and could cause complications like a small piece of bowel gets pinched between the coin or belt and the skin and could lead to a perforation of the intestine.


Surgery when required is usually a day care or maximum 2 day stay surgery. The child is brought to the hospital on the day of operation in the morning. The surgery is done preferably as the first case of the day so that fasting is minimum during waking period of the child. If all goes well, the child can be sent home the same night or may have to stay over at the hospital for the night and leave by next day afternoon. The surgery is done under general anesthesia so the child is totally not conscious of what is happening. A small subumbilical incision is taken and the sac of the hernia is isolated and separated till the muscle edges are seen on both sides. After reducing all the contents into the abdominal cavity, the 2 edges of the muscle are brought together in the midline with multiple non absorbable sutures. The skin is then closed to make the umbilicus look like before minus the protrusion. And looks cosmetically pleasing especially in girls and the scar of the operation is hardly visible in later years of life.


Complications that can occur after the surgery are recurrence, wound infection. Recurrence can occur if the sutures give way partly or totally. Local infection in the wound can occur with or without formation of pus.

Last Updated: 27th January 2009