Umbilical Hernia Surgery in Netanya and Tel Aviv

An umbilical hernia in an adult does not go away on its own, and a belt or pills do not fix it: the only treatment is surgery. A small hernia can be closed through a small incision next to the navel. For larger defects and for diastasis I operate laparoscopically, through three small incisions. Most patients go home the next morning.

What is an umbilical hernia?

An umbilical hernia is a bulge of fatty tissue or a loop of bowel through a weak spot in the abdominal wall at the navel. In infants it often closes by itself, so this page is about adults, in whom it does not close spontaneously.

Risk factors include pregnancy and childbirth, excess weight, chronic cough, constipation, ascites, heavy physical work, diastasis recti and previous abdominal surgery.

Symptoms

• A bulge at the navel that is more noticeable when standing, coughing or straining, and shrinks when you lie down.
• A pulling or burning pain at the navel and discomfort with exertion.
• A cosmetic problem: the navel changes shape and the skin over the hernia becomes thin.

When to seek urgent help. If the bulge becomes hard and painful, will not go back in, the skin over it turns red, or you have nausea, vomiting or a swollen abdomen, it may be strangulated. Do not wait for a consultation: go to the emergency room.

Do you need surgery?

A hernia with symptoms is an indication for planned surgery. It does not disappear and tends to grow, and a large hernia is harder to operate on and more likely to come back. If it becomes strangulated, the operation becomes an emergency and the risks are higher. If you also have diastasis recti, it is usually best to treat both in one operation.

How I operate

I choose the method based on the size of the defect, whether there is diastasis, your weight and any previous operations. For every defect except the smallest I place a mesh, which lowers the risk of recurrence. The operation takes about an hour.

• Open repair: a small incision at the navel, and the defect is closed with sutures or a mesh. Suitable for small hernias, and can be done under local anesthesia with sedation or under spinal anesthesia.
• IPOM+: laparoscopic. A mesh with an anti-adhesion coating is placed inside the abdominal cavity, and the defect is first closed with sutures (that is what the "+" stands for). Quick recovery, three small incisions.
• TAPP: laparoscopic. The mesh is placed in the preperitoneal space and does not touch the bowel.
• e-TEP (extended totally extraperitoneal repair): the mesh sits behind the rectus muscles, away from the bowel. A good choice for large and recurrent hernias and when diastasis is present.

Very large, complex hernias can need open techniques (Component Separation, TAR), but an umbilical hernia rarely does. The advantages of laparoscopy are small incisions, less pain and fewer wound problems around the navel, and the chance to see and close other defects in the abdominal wall during the same operation.

Recovery

• Discharge: The next morning
• Walking and showering: Walking the same day, showering the next day
• Driving: After 2–3 days, when you can brake hard without pain
• Office work: After 3–7 days
• Sport and heavy lifting: After 3–4 weeks; up to 6 weeks after e-TEP with diastasis repair
• For faster recovery and a better cosmetic result, I recommend wearing an elastic abdominal binder for one to two months after surgery.

Pain in the first days is significant, but it is controlled with ordinary painkillers. Mild swelling and bruising around the navel are normal. A follow-up visit is 3–4 weeks after surgery.

Risks

The operation is planned and safe, but like any operation it has risks: seroma (a collection of fluid that usually resolves by itself), hematoma, wound infection (more common in patients with excess weight and in smokers), pain around the mesh, and recurrence. The risk of recurrence is higher with obesity, smoking and large defects, so if you can, lose weight and stop smoking before surgery. We discuss the risks in your own case at the consultation.

Where I operate and insurance coverage

• Private: Assuta, Raphael, Herzliya Medical Center, Atidim.
• Public: Laniado Hospital, Netanya.
• Health funds and insurers: Maccabi, Leumit (Shaban), Clalit (Mushlam), Menora and Clal. With other insurers I see everyone for consultation and operate on patients whose policies have not changed since 2016.

Frequently asked questions

Can an umbilical hernia go away on its own? In infants it often does. In adults it does not: the defect stays and grows.

Is it dangerous to put off surgery? The main risk is strangulation, when bowel or fat is trapped in the hernia opening, which is an emergency. Also, the larger the hernia, the harder the operation.

Do I need a mesh? For a very small defect (less than 1 cm) sutures are sometimes enough. For a larger one, a mesh lowers the risk of recurrence. I decide at the examination.

What anesthesia is used? General for laparoscopy. A small hernia can be repaired openly under local or spinal anesthesia.

What if I also have diastasis recti? It is usually better to repair the hernia and the diastasis in one operation. More in the article on diastasis recti.

See also

Inguinal hernia · Diastasis recti · About me

Book a consultation

I see patients in Netanya and Tel Aviv.

Netanya: appointments via clinic WhatsApp 054-8279900
Tel Aviv: appointments by phone and WhatsApp 052-4713672
A question for me directly: 055-5020812 or the contact form