Indirect umbilical (paraumbilical) hernias protrude above or below the umbilicus and are the most common type of umbilical hernia in adults.
The hernia is a weakness or hole of the tummy button (umbilicus) or tissue around the umbilicus (paraumbilical).
Usually some internal fat or bowel can push through the weak spot / hole making it bulge. This will most likely get bigger and become unsightly if not treated.
Sometimes fat or bowel gets caught in the hernia causing severe pain and vomiting (called strangulation or incarceration) and requires an emergency operation to deal with the problem.
You can be given a local or a general anaesthetic. The choice depends partly on which you prefer, and partly on what your anaesthetist and surgeon think is best.
In some cases when the hernia is relatively small and your general medical condition does not allow you to tolerate the stress of a general anaesthetic, the operation can be done under local anaesthetic.
Having a general anaesthetic means that you will be completely asleep during the operation.
Having a local anaesthetic means that you will be awake during the operation, you will feel that something is being done at the area of the operation but will not feel pain.
A cut is made near the tummy button. Any fat or bowel in the hernia is pushed back or removed. The weakness is mended/closed usually with strong stitches.
Another alternative is to reinforce the weak spot with a piece of synthetic material (mesh). This is usually done when the tissues around the weak spot are not strong enough to be stitched up together with strong stitches or when the weak spot is so big that it is impossible to close it with stitches alone.
The synthetic patch is placed on top of the weak spot and is stitched to the healthy tissues around it. Soon scar tissue develops above and under the patch and this makes it very strong and makes it less likely that the hernia can come back again.
The skin is then closed up, usually with invisible dissolving stitches.
The appearance of your tummy button may change after the operation and rarely may have to be removed, especially if the hernia is large.