Dr A K Bansal provides comprehensive surgical care for umbilical and paraumbilical hernia at Dr Bansal Gastro & Liver Centre, Gomti Nagar Extension and Myra City Hospital, Lucknow. The service covers open suture and mesh repair and laparoscopic mesh repair (IPOM, eTEP) for primary, recurrent and complex adult umbilical hernia. Care is delivered in line with current European Hernia Society (EHS) guidelines on the management of umbilical and epigastric hernia.
An umbilical hernia is a protrusion of abdominal contents through a defect at or close to the umbilicus (navel). In adults, the condition almost always represents an acquired weakness rather than the congenital ring patency seen in children. Although small umbilical hernias may initially appear cosmetic, virtually all symptomatic adult umbilical hernias progress over time and carry an ongoing risk of incarceration and strangulation — particularly in obese patients and women with prior pregnancy-related abdominal wall stretching.
Surgical repair is the only definitive treatment. Modern repair has shifted decisively from pure suture closure to mesh-based reinforcement for defects above approximately 1 cm, reflecting consistent evidence of lower recurrence with mesh. Repair is offered as a day-care or single-overnight procedure in most uncomplicated cases.
Dr A K Bansal offers both open and laparoscopic approaches to umbilical hernia, with technique chosen on the basis of defect size, body habitus, presence of multiple ventral defects, prior abdominal surgery and patient preference. Practice follows the European Hernia Society guidelines for umbilical and epigastric hernia management (Henriksen et al., as endorsed by the EHS) and the recommendations of the International Endo Hernia Society (IEHS) on laparoscopic ventral hernia repair.
The umbilicus is the natural scar of the obliterated umbilical cord and represents an inherently weak point in the linea alba — the midline fibrous raphe of the anterior abdominal wall. Several related hernia types are commonly grouped under the broader umbilical/midline ventral category:
Adult umbilical hernia is acquired and multifactorial. Recognised contributing factors include:
The hallmark presentation is a soft bulge at or near the umbilicus, often first noticed after weight gain, pregnancy or sustained physical strain. The bulge typically enlarges when standing, coughing, straining or lifting, and may reduce on lying down.
Common symptoms include:
Seek urgent care for any of the following: sudden severe pain at the hernia site, a bulge that becomes hard and cannot be pushed back, vomiting, abdominal distension, or fever. These can indicate incarceration or strangulation, which is a surgical emergency.
Diagnosis is usually clinical. Ultrasound of the abdominal wall is the preferred first-line imaging when the diagnosis is uncertain (occult hernia in obese patients, recurrent hernia, or multiple defects). CT scan of the abdomen may be requested for large or complex ventral hernia patterns, recurrent cases, or when planning component separation or mesh placement strategy.
The European Hernia Society guidelines recommend surgical repair in the following situations:
In patients with morbid obesity, cirrhotic ascites or significant cardiopulmonary disease, the timing and approach are individualised. Surgical repair in cirrhotic patients with ascites carries elevated risk and is best managed in a centre with hepatology and HPB surgical input.
Standard pre-operative work-up includes:
Pre-operative weight reduction, smoking cessation and glycaemic optimisation are emphasised because these factors directly influence wound healing, mesh integration and long-term recurrence rates — a principle endorsed by both the EHS and the Americas Hernia Society Quality Collaborative (AHSQC).
Open repair is the standard approach for small to moderate umbilical hernias and is well-suited to day-care surgery. The procedure is performed under spinal, regional or general anaesthesia depending on patient and defect factors.
Key technical steps include:
Laparoscopic repair is increasingly used for larger umbilical defects, recurrent hernia, multiple ventral defects, and obese patients in whom open mesh placement carries higher wound complication risk. Two main techniques are recognised:
Both techniques are endorsed by the International Endo Hernia Society (IEHS) and EAES for selected umbilical and ventral hernia indications.
Most uncomplicated adult umbilical hernia repairs are discharged the same day or the following morning. A typical recovery course:
Wound care follows standard principles — keep the dressing dry for 48 hours, simple analgesia, and removal of any non-absorbable sutures at 10–14 days. Patients are asked to report increasing redness, fever, persistent swelling or drainage, which may indicate infection or seroma.
Recognised complications of umbilical hernia repair include:
Dr A K Bansal completed his M.Ch Surgical Gastroenterology at SGPGI Lucknow with All India Rank 1. He is Ex Senior Consultant in the Department of Gastrosciences at Medanta Hospital and currently heads the Department of GI Surgery at Myra City Hospital. With 15+ years of surgical experience and 5000+ procedures, his hernia practice covers the full spectrum of primary, recurrent and complex adult abdominal wall hernia.
Bring any prior ultrasound or CT scan to your appointment. Walk-in and appointment-based consultations available.
Book AppointmentA protrusion of abdominal contents through a defect at or near the navel. In adults, it is usually acquired and progresses over time. Surgery is the only definitive treatment.
Yes, in most adult cases. EHS guidelines recommend repair for all symptomatic adult umbilical hernias and for asymptomatic defects greater than 1 cm.
True umbilical hernias come through the umbilical ring itself; paraumbilical hernias come through the linea alba just above or below the umbilicus. Both are managed similarly.
For defects above ~1 cm, mesh-based repair is recommended by the EHS due to substantially lower recurrence. Very small defects in slim patients may be repaired with sutures alone.
Yes — laparoscopic IPOM or eTEP is offered for larger defects, recurrent hernia, obese patients and multiple ventral defects. Open repair is equally effective for small primary hernia.
Most patients are discharged the same day or following morning. Light work resumes in 5–7 days; heavy lifting at 4–6 weeks.
Wound infection (1–3%), seroma, haematoma, mesh-related discomfort, and recurrence (under 5% with mesh). Risk increases with obesity, smoking, diabetes and ascites.