Periumbilical hernia

Often, hernias cause no or very few symptoms. The main symptom associated with a periumbilical hernia is a bulge or lump around your naval (belly button). You may notice the following changes affect the lump:

• The lump can be pushed back in or disappears entirely when you lie down.
• The lump appears, or becomes more prominent, when you cough or strain.

In some cases, the hernia can cause extreme pain and vomiting. This is known as strangulation (incarceration) and is caused when fatty tissue or parts of the bowel get caught in the hernia, requiring an emergency operation.

Your GP or consultant will examine the lump and affected area, which is often enough to identify a hernia. It may be necessary to carry out an ultrasound scan. This is a painless and non-invasive procedure, but it will help to confirm the diagnosis and assess how severe it is.

Your GP or consultant is likely to consider the following factors before recommending surgery:

• The risk of strangulation, which can be higher with certain types of hernia, or if the hernia contains muscle, other tissue or parts of your bowel.
• If your symptoms are changing or getting worse.
• The effect it is having on you and your ability to perform everyday tasks.

If periumbilical hernia repair surgery is recommended, the procedure is relatively straightforward. It may involve:

• A general anaesthetic (this takes around 30 minutes).
• Laparoscopic (keyhole) surgery or open surgery
• Keyhole surgery involves two to four tiny cuts made near your naval, so the hernia can be pushed back into your abdomen.
• If the surgery is 'open', a larger cut in skin is made and your recovery time may be longer.
• A special mesh is often used to strengthen the area and prevent the hernia returning. Alternatively, the muscle layers may be stitched together to strengthen them.