Türkçe
ASSOCIATE PROFESSOR SABAHATTİN DESTEK | GENERAL SURGERY SPECIALIST
Umbilical hernia is a condition that occurs as a result of weakening or tearing of the support layer called fascia, which is located on the abdominal wall and prevents the intestines from coming out of the abdomen, in and around the navel.
The incidence of umbilical hernia in adults is between 23% and 50%. The incidence of umbilical hernia peaks between the ages of 31 and 40 in women and between 61 and 70 in men. Umbilical hernias are three times more common in women due to the effects of pregnancy and childbirth and the increased incidence of obesity. Hernias that occur in the navel, 3 cm above and below the navel are classified as umbilical hernias.
Abdominal hernias are more common in obese people, people with prolonged cough, people with prolonged constipation, people who work in heavy jobs, people who lift heavy loads, people with rheumatism, kidney failure, connective tissue disorders, and patients with ascites in the abdomen such as cirrhosis. In addition to pain and swelling, umbilical hernia also draws attention with swelling that is invisible depending on the posture. People may notice an umbilical hernia after increasing pain, especially when they cough.
It is not possible to reduce, correct or eliminate umbilical hernia with medication. On the contrary, waiting may cause the hernia to become larger. The only treatment method is surgery. If the hernia is not causing problems, patients usually choose waiting treatment instead of surgical repair. However, 65% of adult patients with an umbilical hernia will eventually need surgical repair; 3% to 5% of these repairs will be emergency. A hernia that is symptomatic or increasing in size should be repaired.
In later stages, constipation, pain, swelling, vomiting, gas, nausea, vomiting may occur due to an umbilical hernia. In addition, strangulation of the hernia requires urgent surgical intervention. These can also be called hernia strangulation symptoms. If the blood supply to the compressed intestine is completely cut off, intestinal gangrene occurs and intestinal surgery is required.
The physical examination should begin with a visual inspection of the anterior abdominal wall. Skin changes such as discoloration, ulceration or thickening may indicate strangulation. Patients may be referred for abdominal ultrasound and, depending on the situation, abdominal tomography.
Umbilical hernias with a maximum diameter < 2 cm are suitable for primary repair. For umbilical hernias larger than 2 cm in diameter, herniorrhaphy with mesh is preferred. Laparoscopic umbilical hernia repair may be preferred in cases of obesity, multiple abdominal wall defects, concurrent intra-abdominal pathology and repair of a recurrent hernia.
In the open method, 8-10 centimeter skin incisions are made depending on the size of the hernia, while 3 tiny incisions of 1 cm are sufficient in the closed method. Laparoscopy provides easier access to the area to be operated on. In addition, the organs entering the hernia and their condition are more clearly seen. The possibility of recurrence is lower in closed surgery compared to open surgery and patients are discharged in one day. Return to daily life is faster.