Umbilical Hernia

Most umbilical hernias are not emergencies. But in very rare cases, the intestine gets trapped (called incarcerated hernia) in the hole at the belly button. When this happens, your child may have pain in the belly, swelling or discoloration at the hernia site, vomiting or fever. If your child has any of these symptoms, call your healthcare provider or go to the emergency room. Your child may need emergency surgery.

The chances of an emergency due to an incarcerated umbilical hernia are very low when your child is young. Teens and adults are more likely to get an incarcerated umbilical hernia, with belly fat or intestine trapped in the hole.

At the time of surgery, we will give your child medicine (general anesthesia) to make them sleep without pain. Your child’s surgeon will make a very small cut (incision) at the belly button. The surgeon will gently push the bulging tissue back into your child’s abdomen. Next, the surgeon will sew up the opening in the abdominal wall. Finally, the surgeon will close the incision.

The surgery takes about 30 minutes. Your child will be in the recovery room for another hour. Most often, your child can go home the same day as the surgery.

After you get home, you’ll need to keep your child’s cut (incision) clean and dry until it heals. The surgery team will teach you how to care for the incision. They will tell you if you need to limit your child’s activity for a while. In addition:

• We will send you home with pain medicine that will keep your child comfortable.
• You will be given phone numbers so you can reach hospital staff. You can call day or night with any concerns.
• A surgery clinic nurse will call you 5 to 7 days after surgery for a phone follow-up. If all is well, you don’t need to return to the clinic. If you or the nurse has any concerns about your child’s healing, we will set up a visit for you.

If your child needs surgery, you can feel confident in our expertise. We see hundreds of children with umbilical hernias each year at Seattle Children’s. Our surgeons perform a large number of surgeries to correct this condition.

Some people think that surgeons who operate on adults are also experts in the surgical care of infants, children and teens. We don’t agree. Growing bodies are different from adult bodies. The way kids react to surgery – from anesthesia to IV fluids – is different from adults. Hernia Program surgeons are board certified in pediatric surgery, and the doctors who give your child anesthesia are board certified in pediatric anesthesiology.

Seattle Children’s has the only anesthesiology group in the region that has specialized training in pediatric anesthesia. Our anesthesiologists work only with children and teens, providing safe, family-centered care before, during and after surgery. Last year, the team provided anesthesia for more than 20,000 procedures at Seattle Children’s.

Most umbilical hernia surgeries are done at Seattle Children’s Bellevue Clinic and Surgery Center. From check-in through recovery, we put your child’s safety and comfort first. The operating suites are specially designed for children who need day surgeries and are healthy. Your child’s planned procedure is less likely to be delayed because complex emergency surgeries aren’t done here.

Hernia surgeries take place at the Bellevue Clinic and Surgery Center on most Fridays (3 Fridays and 1 Monday a month). On surgery day, you and your child should plan on spending about 3 hours at the surgery center, from the time you walk in the door to the time you leave.

The induction rooms (where your child gets anesthesia), operating rooms and recovery rooms are next door to each other. This means you’ll be able to be with your child right up until they are rolled into the operating room – and again as soon as they open their eyes in a private recovery room. Most children can go back to school 1 to 2 days after surgery.

Your child cannot be treated at Bellevue Clinic and Surgery Center if:

• They are 3 months old or younger
• They have a health problem that could increase their risk of side effects or complications while under anesthesia

In these cases, hernia surgery is performed at Seattle Children’s hospital campus in Seattle.

During surgery, your child is given general anesthesia, which causes them to sleep without pain. Seattle Children’s also uses regional anesthesia, or regional blocks, during hernia surgeries. With a regional block, your doctor uses ultrasound to find the nerves that supply the area being operated on. Then local anesthetics (numbing medicines) are delivered to that area through an injection or a catheter.

Regional blocks have these advantages that many parents find comforting:

• Your child will receive a lighter amount of general anesthesia.
• Most kids will have less nausea and feel more alert after surgery.
• Your child will likely need less pain medicine after surgery.

The effects of a regional block last about 6 hours. The surgeon will send additional pain medicine home with you to make sure your child stays comfortable.