What is the treatment for a patient with an umbilical hernia?

From the Research

Treatment Options for Umbilical Hernia

• Surgery is indicated in symptomatic patients with umbilical hernias, and treatment options should be tailored to the clinical situation 1.
• Open, laparoscopic, and robotic options exist for repair, with each having its advantages and disadvantages 1.
• Mesh should be used for repair, as it has been shown to decrease recurrence rates, even in small hernias 1, 2.

Use of Mesh in Umbilical Hernia Repair

• The European Hernia Society and the Americas Hernia Society recommend placing a non-absorbable (permanent) flat mesh into the preperitoneal space with an overlap of the hernia defect of 3 cm 3.
• Suture repair should only be considered for small hernia defects of less than 1 cm 3.
• The use of a mesh in general is subject to controversial debate, particularly for small (< 2 cm) umbilical hernias 3, 4.

Recurrence Rates and Complications

• Recurrence rates are higher after suture repair (11%) than after mesh repair (1%) 2.
• No relationship was found between wound infection or obesity and umbilical hernia recurrence 4.
• Pain and recurrence rates are significantly less favorable for patients treated with suture repair compared to mesh repair 3.

Patient-Specific Considerations

• Umbilical hernias in children are typically congenital and have a simple surgical treatment with low recurrence rates 5.
• In adults, umbilical hernias have an acquired origin and may require more complex treatment, especially in obese or cirrhotic patients 5.