Thank you team DOSS & Dr. Rayate for changing my life. I have got a rebirth after my weight loss surgery.
A best cadet and a best outgoing student of school; Dr. Neeraj Rayate graduated from Dr. V. M. Medical College, Solapur in merit. He served as a medical officer to Government of Maharashtra at its remote primary health center in Jalgaon district for one year. He then completed his Masters in Surgery from Government Medical College & Civil Hospital, Sangli. He is also a diplomat of national board, New Delhi; in Surgery. He then was a popular teacher in Surgery at Dr. V. M. Medical College, Solapur for 2 years. His urge for excellence brought him to Pune.Read the Rest…
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How is it done?
Vertical sleeve gastrectomy, also known as parietal gastrectomy or just Sleeve gastrectomy consists of an operation that aims, if performed alone, to be restrictive in nature. It is performed by laparoscopy and consists of the restrictive portion of the biliopancreatic diversion +/- duodenal switch bariatric surgical procedure (BPD/DS).
The VSG procedure is often utilized as a first-stage bariatric procedure to reduce surgical risk in high-risk patients by induction of weight loss and this may be its most useful application at the present time (BMI > 60 kg/m2). During this procedure, we create a small, banana-shaped stomach by removing about 85% of the stomach as shown at left. The sleeve is larger than the gastric pouch created during Roux-en-Y Gastric Bypass. The actual surgery takes about 50 minutes.
Weight loss following sleeve gastrectomy results from eating less because of the much smaller stomach. Removing the part of the stomach that produces the hunger hormone (Ghrelin) or some other unidentified factor(s) also contributes to the weight loss.
Weight regain or a desire for more weight loss in very obese patients may require additional surgery in 1-2 years time, such as gastric bypass or biliopancreatic diversion with duodenal switch.
What Are the Benefits?
Preliminary studies show that patients after VSG lose 50-60% of their extra weight in the first 2 years after the surgery. Unlike the gastric bypass or BPD/DS that have excellent weight loss results after 15+ years of follow-up, there is no data on weight loss with VSG alone beyond 6 years. Studies are ongoing.
More recent research shows that VSG is a viable alternative for those patients who feel the gastric bypass is “too much” surgery and the Lap Band is not for them due to long term failures and complications. Studies are ongoing.
In addition to this weight loss, if you have any of these conditions, they will improve or resolve after the surgery:
Type 2 Diabetes
High blood pressure
Low back pain
Weight-bearing arthritis of the hips, knees, ankles, and feet
Skin fold dermatitis
Urinary stress incontinence
Finally, the health benefits gained with gastric bypass surgery can reduce your risk of death by as much as 89% compared to staying morbidly obese. For more details please explore the section “Reasons why to opt for Weight Loss Surgery”.
What are the situations where this surgery should not be done?
Lung disease requiring oxygen therapy
Extremely limited mobility
Untreated psychiatric disorders and substance abuse or narcotic dependency
Endocrine disorders such as Cushing’s Syndrome and Prader Willi Syndrome
Drug or alcohol abuse
Inability to cope with the changes in diet and life modification after surgery
Refusal to be assessed by psychologist or psychiatrist
Complex medical conditions increase the risk of surgery and are considered on a patient-by-patient basis.
Shop No – 6, Puneet Yash Arcade, Karve Road,
Opp Hotel Kokan Express,
Near Kothrud Bus Stand,
Pune- 411052, India
Sohrab Hall, 4th Floor,
Oppo. Jehangir Hospital,
Pune- 411001, India
This procedure uses a sterile, 3-D device – "The Prolene 3D Patch Mesh" that performs a few simple steps to repair hernia without pain in the treatment for both direct & indirect inguinal hernia repair. 'Mesh' which is also known as 'patch' or 'screen', is used by most of hernia surgeons worldwide because it has smaller incisions, minimum number of sutures, is done under local anesthesia and the patient is discharged as early as 24 hrs after the surgery.
Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder holds a digestive fluid called bile that's released into your small intestine.
Gallstones range in size from as small as a grain of sand to as large as a golf ball. Some people develop just one gallstone, while others develop many gallstones at the same time.
Gallstones are common in the United States. People who experience symptoms from their gallstones usually require gallbladder removal surgery. Gallstones that don't cause any signs and symptoms typically don't need treatment.
Treatment options for gallstones include:
A surgery is recommended to remove your gallbladder, since gallstones frequently recur. Once your gallbladder is removed, bile flows directly from your liver into your small intestine, rather than being stored in your gallbladder. You don't need your gallbladder to live, and gallbladder removal doesn't affect your ability to digest food, but it can cause diarrhea, which is usually temporary.
Medications you take by mouth may help dissolve gallstones. But it may take months or years of treatment to dissolve your gallstones in this way. Sometimes medications don't work. Medications for gallstones aren't commonly used and are reserved for people who can't undergo surgery.
SILS (Single incision laparoscopic surgery) is a recently developed technique in laparoscopic surgery. It is a minimally invasive surgical procedure in which the surgeon operates almost exclusively through a single entry point, typically the patient’s navel.
The surgery is also known asSingle-port laparoscopy (SPL), single-port access surgery (SPA), single-port incisionless conventional equipment-utilizing surgery (SPICES), Single-access endoscopic surgery (SAES), laparo-endoscopic single-site surgery (LESS), natural-orifice transumbilical surgery (NOTUS), and one-port umbilical surgery (OPUS).
Proctology includes all anorectal ailments namely Piles, Constipation, Fistula, Fissure, Pilonidal Sinus &Prolapse .Inamdar Hospital introduces this innovative speciality to all its patients who can now be completely cured from their daily woes of anorectal problems. Dr Ashwin Porwal, ColoProctosurgeon who heads the Proctology Department of Indamdar Hospital focuses on the following :
PILES… A Lifestyle Disease
PILES (clinically known as Haemorrhoids) basically, is the swelling of blood vessels near the anal opening. The lumps are formed by increased pressure on blood vessels in the area, causing them to enlarge and swell. We understand that piles may not be a subject you feel comfortable talking about, but there is no need to suffer in silence.
Grades of Piles….
1) Grade I – Symptoms are mild pain, itching sensation, heaviness where patient can be cured with medicine and diet and Healing Hands Innovative Ayurvedic Therapy.
2) Grade II – Symptoms are painful defecation, recurrent bleeding, itching sensation, burning sensation, dragging sensation, and feeling of prolapse which reduces automatically after motion. This may require surgical intervention.
3) Grade III – Symptoms are painful defecation, recurrent bleeding, itching sensation, burning sensation, dragging sensation, and feeling of prolapse which may require finger reduction after motion. This requires surgical intervention.
4) Grade IV – Symptoms worsen and the prolapse is irreducible. This requires surgical intervention.
Innovative treatment for Piles : STAPLER Surgery
Procedure : It is a minimally invasive painless procedure that reduces the prolapsed HAEMORRHOIDAL (PILES) tissue. A unique stapling technique that is used to push the swollen blood vessels back into their normal position.Preparation : Requires patient to take nothing by mouth about 4 hrs prior to the surgery.Surgery : The surgery takes only about 20 to 30 minutes. It is usually done under spinal anesthesia. It is done through a natural opening (anus), with the help of a use and throw device known as Stapler. In this surgery as there are no cuts and no stitches outside so there is no need of dressing. Post Operative Care (after surgery care) : Patient can have full diet 4 hrs post surgery. He/she can walk around just after 5–6 hrs of the surgery. Patient can be discharged within a span of 24 hrs. On discharge antibiotics and painkiller for7 to 10 days are advised.Recovery : Patient normally gets discharged from the hospital within 24 hrs. The recovery period is relatively very short. Patient can resume daily routine after discharge and join work after 3 days.
Constipation is often one of those topics, very few people like to discuss. It occurs when bowel movements become difficult or less frequent. Constipation is not a disease, but a symptom related to a family of diseases generally classified as 'defecation disorders'.
How do you know..If you suffer from Chronic Constipation?
The following self-assessment can help you determine whether or not you may suffer from chronic constipation.
If you have experienced at least two of above symptoms for at least three months, you may have chronic constipation.
If you have Obstructed Defecation Syndrome (ODS) – A type of Chronic Constipation?
If you have chronic constipation and also have one or more of the following symptoms at least 25% of the time during bowel movements, you may have ODS:
Lucky STARR for Constipation :
Treatment Option :Most of the time, chronic constipation can be relieved using a combination of Diet, Exercise, Medication and Pelvic Floor Physiotherapy.If these approaches do not relieve your chronic constipation, you should discuss treatment options with a Proctosurgeon as you may be suffering from a type of Chronic Constipation known as Obstructed Defecation Syndrome (ODS).Diagnosis : MRI Defecography is a must.
An Advanced Treatment for ODS : STARR SURGERY
Relief from Chronic ConstipationSTARR (Stapled Trans Anal Rectal Resection) is a surgical procedure that is performed through the anus, requires no external cuts and leaves no visible scars. Using 2 surgical staplers, the procedure removes excess tissue in the rectum and reduces the deformities that causes ODS. Patients undergoing STARR are typically hospitalized for 24 Hrs. STARR surgery has a minimal recovery time after leaving the hospital.
MRI DEFECOGRAPHY :
SYSTEMATIC APPROACH TO CONSTIPATION
Defecography (Scanning of evacuation) is a MAGNETIC RESONANCE IMAGING (MRI) study of defecation, a diagnostic test that shows the rectal & anal canal as they change during defecation (having a bowel movement). This test is used to evaluate disorders of the lower bowel that are not evident by tests such as colonoscopy or Sigmoidoscopy.
WHO MAY HAVE TO GO FOR THIS DIAGNOSTIC TEST
Preparation & Technique for the Procedure :
A jelly paste around 300 to 400 ml is inserted in the anal region of the patient & he is asked to defecate it. All the images during the defecation process are recorded.This technologically advanced investigation is available at a very few places in India. In Maharashtra it is available in Mumbai & Pune.
In Pune it is done only at Fidelity Diagnostics in association with Healing Hands Clinic, located at Inamdar Hospital, Fatima Nagar under the guidance of Proctosurgeon Dr. Ashwin Porwal and his team of trained doctors, staff and an experienced radiologist.
The anorectal Fistula (Fistula in Ano) is an abnormal communication between the anus and perianal skin. Fistula can occur spontaneously or secondary to perianal or perirectal abscess.
Causes of FISTULA :
Fistula has a track having 2 openings : Internal in the Rectum or Anus & External in the buttocksDiagnosis : MRI Fistulogram
VAAFT- Video Assisted Anal Fistula Treatment
RECTAL PROLAPSE :
What is it?
Rectal prolapse is a condition in which the Rectum (the lower end of the colon, located just above the anus) becomes stretched out and protrudes out of the anus.
After Care :
Cancer of the Rectum
The dreaded ‘C’ word- Dealing with Cancer of the Rectum Cancer has become an epidemic to say the very least. Aptly termed ‘Emperor of Maladies’ it has become a nightmare for both the patients and their doctors. But what works in the favor of life and a chance at complete recovery is ‘Prevention’ and ‘Early Detection’.
This principle also applies to cancer developing in the Colo-Rectal Region. Cancer of the rectum is more prevalent in men above 50.
Diagnosis :Colonoscopy & Biopsy
Screening for Cancer Rectum for early Diagnosis
We, at HHC, have been supporting campaigns to aid ‘Prevention of Cancer of the Rectum’ through dietary recommendations such as high fibre diet and early detection by screening tests.TREATMENT : Depends on Stage, Early Stage can be Cured with Surgery.
An anal fissure is a break or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on the toilet paper, sometimes in the toilet. If acute they may cause pain after defecation but with chronic fissures pain intensity is often less.Causes of FISSURE :Constipation
Delivery & Pregnancy
Childbirth trauma in womenTREATMENT : 1) Healing Hands Innovative Ayurvedic Therapy 5 – 6 sessions
(Oil Therapy) of short 10 mins for 5 – 7 days in continuity.2) If nothing works : Painless Surgery by
Radiofrequency (LASER) is the last option.
When Digestion becomes Disruptive…It’s time to beat bloating, acidity, heartburn and the headaches they bring with them
We ingest, the body digests. The story of the food we eat and the nourishment we obtain from it is supposed to be as simple as that. But what if things go a little awry? Early in school we are taught that digestion – simple though it may appear to be- is actually a complex procedure that begins in the mouth itself and involves the esophagus, the stomach and the intestines.
We, at HHC can help you to determine the root cause of your digestive disease by detailed dietary history and can treat you
with minimal medications , Herbals and lifestyle modifications. Conditions like appendicitis and cholecystitis (Gall bladder stone ) can be treated by Laparoscopic surgery.
A hiatal hernia occurs when part of your stomach pushes upward through your diaphragm. Your diaphragm normally has a small opening (hiatus) through which your food tube (esophagus) passes on its way to connect to your stomach. The stomach can push up through this opening and cause a hiatal hernia.In most cases, a small hiatal hernia doesn't cause problems, and you may never know you have a hiatal hernia unless your doctor discovers it when checking for another condition. But a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn. Self-care measures or medications can usually relieve these symptoms, although a very large hiatal hernia sometimes requires surgery.
A hiatal hernia occurs when weakened muscle tissue allows your stomach to bulge up through your diaphragm. It's not always clear why this happens, but pressure on your stomach may contribute to the formation of hiatal hernia.How a hiatal hernia forms Your diaphragm is a large dome-shaped muscle that separates your chest cavity from your abdomen. Normally, your esophagus passes into your stomach through an opening in the diaphragm called the hiatus. Hiatal hernias occur when the muscle tissue surrounding this opening becomes weak, and the upper part of your stomach bulges up through the diaphragm into your chest cavity.Possible causes of hiatal hernia Hiatal hernia could be caused by:Injury to the area
Being born with an unusually large hiatus
Persistent and intense pressure on the surrounding muscles, such as when coughing, vomiting, or straining during a bowel movement or while lifting heavy objects
Small hiatal hernias Most small hiatal hernias cause no signs or symptoms.Large hiatal hernias Larger hiatal hernias can cause signs and symptoms such as:Heartburn
Belching Difficulty swallowing
Tests and Diagnosis
A hiatal hernia is often discovered during a test or procedure to determine the cause of heartburn or chest or upper abdominal pain. Such tests or procedures include:An X-ray of your upper digestive tract. During a barium X-ray, you drink a chalky liquid containing barium that coats your upper digestive tract. This provides a clear silhouette of your esophagus, stomach and the upper part of your small intestine (duodenum) on an X-ray.Using a scope to see inside your digestive tract. During an endoscopy exam, your doctor passes a thin, flexible tube equipped with a light and video camera (endoscope) down your throat and into your esophagus and stomach to check for inflammation.
Treatments and drugs
Most people with hiatal hernia don't experience any signs or symptoms and won't need treatment. If you experience signs and symptoms, such as recurrent heartburn and acid reflux, you may require treatment, which can include medications or surgery.Medications for heartburn If you experience heartburn and acid reflux, your doctor may recommend medications, such as:Antacids that neutralize stomach acid. Over-the-counter antacids, such as Gelusil, Maalox, Mylanta, Rolaids and Tums, may provide quick relief.Medications to reduce acid production. Called H-2-receptor blockers, these medications include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) and ranitidine (Zantac 75). Stronger versions of these medications are available in prescription form.Medications that block acid production and heal the esophagus. Proton pump inhibitors block acid production and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24HR) and omeprazole (Prilosec OTC). Stronger versions of these medications are available in prescription form.Surgery to repair a hiatal hernia In a small number of cases, a hiatal hernia may require surgery. Surgery is generally reserved for emergency situations and for people who aren't helped by medications to relieve heartburn and acid reflux. Hiatal hernia repair surgery is often combined with surgery for gastroesophageal reflux disease.An operation for a hiatal hernia may involve pulling your stomach down into your abdomen and making the opening in your diaphragm smaller, reconstructing a weak esophageal sphincter, or removing the hernia sac. In some cases, this is done using a single incision in your chest wall (thoracotomy) or abdomen (laparotomy). In other cases, your surgeon may insert a tiny camera and special surgical tools through several small incisions in your abdomen. The operation is then performed while your surgeon views images from inside your body that are displayed on a video monitor (laparoscopic surgery).
Inguinal Hernia By DOSS
An inguinal hernia occurs when soft tissue — usually part of the membrane lining the abdominal cavity (omentum) or part of the intestine — protrudes through a weak point in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object.An inguinal hernia isn't necessarily dangerous by itself. It doesn't get better or go away on its own, however, and it can lead to life-threatening complications. For this reason, your doctor is likely to recommend surgery to fix an inguinal hernia that's painful or becoming larger. Inguinal hernia repair is a common surgical procedure.
Some inguinal hernias don't cause any symptoms. You might not know you have one until your doctor discovers it during a routine medical exam. Often, however, you can see and feel the bulge created by the hernia. The bulge is usually more obvious when you stand upright, especially if you cough or strain. Inguinal hernia signs and symptoms include:A bulge in the area on either side of your pubic boneA burning, gurgling or aching sensation at the bulgePain or discomfort in your groin, especially when bending over, coughing or liftingA heavy or dragging sensation in your groinWeakness or pressure in your groinOccasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotumYou should be able to gently and easily push the hernia back into your abdomen when you're lying down. If not, applying an ice pack to the area may reduce the swelling enough so that the hernia slides in easily. Lying with your pelvis higher than your head also may help.Incarcerated hernia If you aren't able to push the hernia in, the omentum or a loop of intestine can be trapped (incarcerated) in the abdominal wall. An incarcerated hernia can lead to a strangulated hernia, which cuts off the blood supply to your intestine. Surgery is needed to repair the hernia and restore blood supply to the bowel. A strangulated hernia can be life-threatening if it isn't treated.Signs and symptoms of strangulated hernia include:Nausea, vomiting or both
Rapid heart rate
Sudden pain that quickly intensifies
A hernia bulge that turns red, purple or dark
If any of these signs or symptoms occurs, call your doctor right away.Signs and symptoms in children Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia may be visible only when an infant is crying, coughing or straining during a bowel movement. In an older child, a hernia is likely to be more apparent when the child coughs, strains during a bowel movement or stands for a long period of time.When to see a doctor See your doctor if you have a painful or noticeable bulge in your groin on either side of your pubic bone. The bulge is likely to be more noticeable when you're standing upright, and you usually can feel it if you put your hand directly over the affected area. Seek immediate medical care if a hernia bulge turns red, purple or dark.
Some inguinal hernias have no apparent cause. Others occur as a result of:Increased pressure within the abdomen
A pre-existing weak spot in the abdominal wall
A combination of increased pressure within the abdomen and a pre-existing weak spot in the abdominal wall
Straining during bowel movements or urination
Fluid in the abdomen (ascites)
Chronic coughing or sneezing
In many people, the abdominal wall weakness that leads to an inguinal hernia occurs at birth when the abdominal lining (peritoneum) doesn't close properly. Other inguinal hernias develop later in life when muscles weaken or deteriorate due to factors such as aging, strenuous physical activity or coughing that accompanies smoking.In men, the weak spot usually occurs in the inguinal canal, where the spermatic cord enters the scrotum. In women, the inguinal canal carries a ligament that helps hold the uterus in place, and hernias sometimes occur where connective tissue from the uterus attaches to tissue surrounding the pubic bone.More common in men Men are more likely to have an inherent weakness along the inguinal canal because of the way males develop before birth.In male babies, the testicles form within the abdomen and then move down the inguinal canal into the scrotum. Shortly after birth, the inguinal canal closes almost completely — leaving just enough room for the spermatic cord to pass through but not enough to allow the testicles to move back into the abdomen. Sometimes, the canal doesn't close properly, leaving a weakened area.In female babies, there's less chance that the inguinal canal won't close after birth.Weaknesses can also occur in the abdominal wall later in life, especially after an injury or a surgical operation in the abdominal cavity. Whether or not you have a pre-existing weakness, extra pressure in your abdomen from straining, heavy lifting, pregnancy or excess weight can cause a hernia.
Risk factors for an inguinal hernia include:Being male. You're far more likely to develop an inguinal hernia if you're male. Also, the vast majority of newborns and children who develop inguinal hernias are boys.Family history. Your risk of inguinal hernia increases if you have a close relative, such as a parent or sibling, who has the condition.Certain medical conditions. People who have cystic fibrosis, a life-threatening condition that causes severe lung damage and often a chronic cough, are more likely to develop an inguinal hernia.Chronic cough. A chronic cough, such as from smoking, increases your risk of inguinal hernia.Chronic constipation. Straining during bowel movements is a common cause of inguinal hernias.Excess weight. Being moderately to severely overweight puts extra pressure on your abdomen.Pregnancy. This can both weaken the abdominal muscles and cause increased pressure inside your abdomen.Certain occupations. Having a job that requires standing for long periods or doing heavy physical labor increases your risk of developing an inguinal hernia.Premature birth. Infants who are born early are more likely to have inguinal hernias.History of hernias. If you've had one inguinal hernia, it's much more likely that you'll eventually develop another — usually on the opposite side.
Complications of an inguinal hernia include:Pressure on surrounding tissues. Most inguinal hernias enlarge over time if they're not repaired surgically. Large hernias can put pressure on surrounding tissues. In men, large hernias may extend into the scrotum, causing pain and swelling.Incarcerated hernia. If the omentum or a loop of intestine becomes trapped in the weak point in the abdominal wall, it can obstruct the bowel, leading to severe pain, nausea, vomiting, and the inability to have a bowel movement or pass gas.Strangulation. An incarcerated hernia may cut off blood flow to part of your intestine. This condition is called strangulation, and it can lead to the death of the affected bowel tissue. A strangulated hernia is life-threatening and requires immediate surgery.
Tests and diagnosis
A physical exam is usually all that's needed to diagnose an inguinal hernia. Your doctor is likely to ask about your signs and symptoms and to check for a bulge in the groin area. Because standing and coughing can make a hernia more prominent, you may be asked to stand up and cough or strain as part of the exam.
Treatments and drugs
If your hernia is small and isn't bothering you, your doctor may recommend a watch-and-wait approach. Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications.There are two general types of hernia operations — open hernia repair and laparoscopic repair.Herniorrhaphy In this procedure, also called an open hernia repair, the surgeon makes an incision in your groin and pushes the protruding omentum or intestine back into your abdomen. The surgeon then sews together the weakened or torn muscle. The weak area often is reinforced and supported with a synthetic mesh (hernioplasty).After the surgery, you'll be encouraged to move about as soon as possible, but it may be four to six weeks before you're fully able to resume your normal activities.Laparoscopy In this minimally invasive procedure, the surgeon operates through several small incisions in your abdomen. A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through another incision to repair the hernia using synthetic mesh.Most people who have laparoscopic repair experience less discomfort and scarring after surgery and a quicker return to normal activities. Laparoscopy may be a good choice for people whose hernias recur after traditional hernia surgery because it allows the surgeon to avoid scar tissue from the earlier repair. Laparoscopy also may be a good choice for people with hernias on both sides of the body (bilateral inguinal hernias).Some studies indicate that a laparoscopic repair may have an increased risk of complications and of recurrence following surgery. These risks can be reduced if the procedure is performed by a surgeon with extensive experience in laparoscopic hernia repairs.Laparoscopic hernia repair may not be for you if:You have a very large hernia
Your intestine is pushed down into the scrotum
You've had previous pelvic surgery, such as prostate surgery (prostatectomy)
You can't receive general anesthesia
Umbilical Hernia By DOSS
An umbilical hernia occurs when part of the intestine protrudes through an opening in the abdominal muscles. Umbilical hernia is a common and typically harmless condition. Umbilical hernias are most common in infants, but they can affect adults as well. In an infant, an umbilical hernia may be especially evident when the infant cries, causing the baby's bellybutton to protrude. This is a classic sign of an umbilical hernia.Many umbilical hernias close on their own by age 1, though some take longer to heal. To prevent complications, umbilical hernias that don't disappear by age 3 or those that appear during adulthood may need surgical repair.
An umbilical hernia creates a soft swelling or bulge near the navel (umbilicus). If your baby has an umbilical hernia, you may notice the bulge only when he or she cries, coughs or strains. The bulge may disappear when your baby is calm or lies on his or her back.Umbilical hernias in children are usually painless. Umbilical hernias that appear during adulthood may cause abdominal discomfort.When to see a doctor If you suspect that your baby has an umbilical hernia, talk with your child's pediatrician. Seek emergency care if your baby has an umbilical hernia and:Your baby appears to be in pain
Your baby begins to vomit
The bulge becomes tender, swollen or discoloredSimilar guidelines apply to adults. Talk with your doctor if you have a bulge near your navel. Seek emergency care if the bulge becomes painful or tender. Prompt diagnosis and treatment can help prevent complications.
During pregnancy, the umbilical cord passes through a small opening in the baby's abdominal muscles. The opening normally closes just after birth. If the muscles don't join together completely in the midline of the abdomen, this weakness in the abdominal wall may cause an umbilical hernia at birth or later in life.In adults, too much abdominal pressure can cause an umbilical hernia. Possible causes in adults include:Obesity
Fluid in the abdominal cavity (ascites)
Previous abdominal surgery
Umbilical hernias are most common in infants — especially premature babies and those with low birth weights. Black infants appear to have a slightly increased risk of umbilical hernias. The condition affects boys and girls equally.For adults, being overweight or having multiple pregnancies may increase the risk of developing an umbilical hernia. This type of hernia tends to be more common in women in their 50s or 60s.
For children, complications of an umbilical hernia are rare. Complications can occur when the protruding abdominal tissue becomes trapped (incarcerated) and can no longer be pushed back into the abdominal cavity. This reduces the blood supply to the section of trapped intestine and can lead to umbilical pain and tissue damage. If the trapped portion of intestine is completely cut off from the blood supply (strangulated hernia), tissue death (gangrene) may occur. Infection may spread throughout the abdominal cavity, causing a life-threatening situation.Adults with umbilical hernia are somewhat more likely to experience incarceration or obstruction of the intestines. Emergency surgery is typically required to treat these complications.
Tests and diagnosis
An umbilical hernia is diagnosed during a physical exam. Sometimes imaging studies — such as an abdominal ultrasound or X-ray — are used to screen for complications.
Treatments and drugs
Most umbilical hernias in babies close on their own by 18 months. Your doctor may even be able to push the bulge back into the abdomen during a physical exam. Don't try this on your own, however. Although some people claim a hernia can be fixed by taping a coin down over the bulge, this "fix" doesn't help and germs may accumulate under the tape, causing infection.For children, surgery is typically reserved for umbilical hernias that:Are painful
Are bigger than 1.5 centimeters in diameter (slightly larger than a 1/2 inch)
Don't decrease in size after six to 12 months
Don't disappear by age 3
Become trapped or block the intestinesFor adults, surgery is typically recommended to avoid possible complications — especially if the umbilical hernia gets bigger or becomes painful.During surgery, a small incision is made at the base of the bellybutton. The herniated tissue is returned to the abdominal cavity, and the opening in the abdominal wall is stitched closed. In adults, surgeons often use mesh to help strengthen the abdominal wall. Recurrences are unlikely.