What is an umbilical hernia?
An umbilical hernia is a protrusion of intestines or fatty tissue from the abdominal cavity through a weakness in the abdominal wall near the navel. This causes a bulge around or close to the navel and can vary in size. Umbilical hernias are seen in both children and adults, though the causes may differ.
Why do umbilical hernias occur?
In children, it is typically due to the abdominal wall not being fully developed at birth, whereas in adults, it often arises from increased pressure on the abdominal wall, as in cases of obesity, pregnancy, or physical strain. Certain genetic factors may also increase the risk of umbilical hernias, though more research is needed to clarify the precise genetic connections.
Risk of complications with umbilical hernias
In some cases, an umbilical hernia may become strangulated, meaning that blood supply to the tissue is impaired or completely stopped. This is a serious condition that requires urgent surgical intervention, as it can lead to tissue death. Although many umbilical hernias are harmless and only require treatment if symptoms or cosmetic concerns arise, patients should be mindful of symptoms like pain or discomfort around the navel.
The patient's journey from general practitioner to specialist
The process often begins when a patient notices a bulge near the navel and consults their general practitioner. Some patients may be referred for an ultrasound to confirm the diagnosis, though a clinical examination is usually sufficient. If the hernia causes discomfort, the patient is referred for a surgical assessment, where the surgeon and patient together decide whether surgery is needed and which type of surgery should be performed.
Historical development of surgical techniques
In the past, umbilical hernias were operated on without the use of mesh, resulting in a higher risk of recurrence. Today, surgeons often use a synthetic mesh to reinforce the area around the hernia, reducing the risk of recurrence. The laparoscopic technique (keyhole surgery) has also become a popular approach for larger umbilical hernias, where the hernia is repaired through small incisions, and a mesh is placed on the inside of the abdominal wall to strengthen weak areas.
Risk of recurrence and chronic pain
Although the risk of recurrence has been reduced with modern surgical techniques, some patients may still experience chronic pain after surgery. However, this is now rarer and is the subject of extensive research to further minimize this risk. To understand patients' long-term quality of life after surgery, studies focus on both pain relief and freedom from recurrence. The "AfterHernia" project is part of this research activity, aiming to provide better treatment for individual patients in the future.
Current and future research areas
Current research areas in umbilical hernia treatment focus on improving surgical materials and better understanding the genetic factors behind hernia formation. Efforts are being made to develop biocompatible meshes that integrate more naturally into the body, along with methods for more individualized treatment approaches. In the future, there is also the hope of being able to prevent or treat hernias medically rather than surgically—possibly even a "hernia pill"—though this is still a long way off.