Umbilical Hernia Repair in Western Australia

An umbilical hernia is a bulge in the abdominal wall that comes out through, or right next to, the belly button (umbilicus). The umbilicus is a naturally weak point in the abdominal wall because of where the umbilical cord passed through it before birth — and through life, that small opening can stretch and allow fat or, less commonly, a loop of bowel to push through.

Umbilical hernias are very common in adults. They often appear gradually over months or years and may be first noticed as a soft, often round bulge at the belly button that becomes more obvious when you stand, cough, lift, or strain. Many umbilical hernias are uncomfortable rather than painful — patients describe a dull ache, a pulling sensation, or pain that worsens through the day or with heavy work.

The closely related "ventral" hernia is a hernia anywhere along the midline of the abdomen — above, below, or beside the umbilicus — that has not occurred at the site of a previous surgical scar. (Hernias through scars are described as incisional hernias and are covered on a separate page.) Small ventral and umbilical hernias are repaired in similar ways and the consultation, surgical, and recovery process is very similar.

Umbilical hernias do not heal by themselves. The size of the bulge generally increases over time as the opening enlarges, and the risk that fat or bowel becomes trapped inside it slowly rises. For these reasons surgical repair is usually recommended, especially if the hernia is symptomatic, large, or causing concern.

Umbilical hernias develop because the small natural opening through the abdominal wall at the navel gradually stretches and weakens. Anything that repeatedly raises pressure inside the abdomen can contribute: pregnancy (particularly multiple pregnancies), being overweight, rapid weight gain or loss, chronic cough, constipation and straining, ascites (fluid in the abdomen from liver disease), and heavy or repetitive lifting at work.

Most adult umbilical hernias are acquired rather than congenital. (Many infants have a small umbilical hernia at birth that closes by itself by age four — adult umbilical hernias are different and do not close spontaneously.) Adult umbilical hernias are seen across both sexes but are particularly common in women after pregnancy and in men whose work involves heavy lifting.

Umbilical and small ventral hernia repair can be performed open or laparoscopically. The decision depends on the size of the hernia, your weight and body shape, whether you have had previous abdominal surgery, and your overall health.

Open repair

The traditional approach. Performed through a small incision near the belly button, often hidden in the natural crease so the cosmetic result is good. Small hernias (less than about 2 cm) may be repaired with strong sutures alone; larger hernias are reinforced with a small piece of mesh placed behind or in front of the muscle wall. Most patients go home the same day.

Laparoscopic (keyhole) repair

Performed through three small incisions away from the hernia itself, with mesh placed inside the abdomen against the muscle wall. Laparoscopic repair is often the preferred option for larger hernias, for patients with multiple small midline hernias, and for patients with a higher body mass index where wound complications after open repair are more likely.

Robotic repair

Some Perth hospitals also offer robotic-assisted hernia repair, which is a refinement of laparoscopic surgery. Dr Watson will discuss whether this is appropriate, available, and a meaningful upgrade in your specific case.

Whichever approach is used, the principles are the same: reduce the contents back into the abdomen, repair the defect, and reinforce the area to reduce the chance of recurrence.

Recovery from umbilical or small ventral hernia repair is generally straightforward. Most patients with desk-based work return to work within one to two weeks. Light manual work usually takes three to four weeks. Heavy manual work, FIFO, and mining roles typically require around six weeks before unrestricted lifting. These are general guidelines, not guarantees.

Expect bruising and tenderness around the navel for one to two weeks. You may feel a firm ridge or thickening under the skin where the mesh sits — this softens over weeks and months. You will be encouraged to walk from the day of surgery, with a gradual increase in activity as comfort allows. Driving is usually possible after one to two weeks. Dr Watson will review you in person or by telehealth two to four weeks after surgery.