Umbilical hernias are usually present from the time of birth. Some are repaired in childhood while others enlarge slowly and present later in life. Most are small and asymptomatic and do not require repair. Bowel or omentum (intra-abdominal fat) may herniate through the defect and cause symptoms.
Using the same principles of tension free hernia repair, umbilical hernias over 2 cm in diameter should be repaired using mesh. Conventional techniques to repair these hernias by simply closing the defect with stitches place the muscle tissue under significant tension leading to higher rates of recurrence. The tension free version of this operation can either be performed by placing mesh behind the muscles as an open operation under local anesthesia or using a laparoscopic technique depending on the individual circumstance and preference. The navel is unaffected and patients are typically discharged on the same day as surgery.