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Hernia above belly button – surgery or no?
I am 38, and ten years ago I had a wound as a result of a bowel obstruction surgery that got infected and had to heal from the inside out. I felt OK for about 9 years, but then I started having pain during situps and crunches. It also hurts a little when I breathe or eat a large meal. I had it looked at and scanned and I have a 5 cm hernia above my belly button. We are not sure how big it was before, but it hurts and it bulges just a bit just at rest. I had three doctors look at it and all agreed it would not be a risk for an emergency such as a bowel obstruction. They said I would feel stronger if I had it repaired, but I would need a total abdominal wall reconstruction with mesh, by using the external oblique muscles to connect to each other. They all said that if I could just live with the hernia for now I don’t NEED the surgery. However, I am so limited, and I miss feeling strong and capable. I sometimes wear an abdominal binder which makes me more confident. I was told, the bigger it gets the harder the surgery and recovery will be, but also I don’t really want to take the risk and get this huge surgery, and also I have already had 2 abdominal surgeries (open) which means the more, the more risk and I am still so young. I am fearful when I exercise that I am making it bigger, but I feel more pain when I don’t exercise the area. If anyone has advice or thoughts I’d love to hear it. If I could have the surgery and I knew it would go great I would totally get it, but I am afraid if it doesn’t go well what will happen to my body.
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5 Replies
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Sounds like an incisional hernia.
If one has symptoms, it’s best to repair. Otherwise, can watch., usually.
Repair requires mesh. I prefer to place the mesh away from the intestines in these situations, especially given the past history of intestinal obstruction.
Malls, type of infection in the past is important. I change the type of mesh use if it was MRSA infection. -
[USER=”2952″]TheWayBackUp[/USER] Of course. If you want to avoid another large scar and long recovery, then robotic AWR would be the superior option. I think it only involves four little incisions, three that are 5mm and one 12mm for the camera port. Like I said, the two surgeons I mentioned really have seemed to mastered and the studies they put out seem to be really promising. They’re both very vocal and well known in the hernia world. You can also see some testimonials from patients online too. Also if you do decide to go with either of them, good thing is that there aren’t far from you.
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Surgery #1 2008: Emergency Cecal Volvulus Bowel Obstruction where they ended up removing my cecum and ascending colon. It was emergency, and it got infected but left only a thin 3 inch horizontal scar next to my belly button.
After about 4-6 months I was back to vigorous exercise and basically felt almost as good as new just rehabbing myself. However I’m a personal trainer and pretty knowledgeable about health and exercise. I started with exercising seated in machines etc. to keep the core out of it, then gradually added back easy core exercises that were pain free and eventually got back to just about 100% strength of what I had before.
Surgery #2 2009: Emergency Small Bowel Obstruction where they removed a blockage and a couple of inches of my small intestine. This one got badly infected and I was left with about a 6 inch vertical scar up my midline from 4 inches below belly button to 2 inches above. But it had to be opened and it took almost 6 weeks to heal and was a big wide scar kind of looking like a small cucumber in shape/size.
Again after 4-6 months I started getting back to feeling myself strength wise, however this time I wore an abdominal binder for about 3 years especially during vigorous sports. I ended up getting as strong as ever in my core over the years especially once I no longer felt that the binder helped support (I no longer felt better with the brace by this time, although I seem to have figured out how to recruit other muscles rather than use the weakened area for a lot of things). I had been told right after surgery #2 that I would need a repair type surgery, and that person at the time seemed to think it would be a pigskin type, but that I would have to wait 2 years to be healed enough to get it. Well, at the 2 year mark I felt very good and the surgeon I saw didn’t want to do a surgery if I felt good.
I haven’t had bowel issues at all since 2012, at that time I had a bowel obstruction where I was hospitalized but never needed surgery.
I saw two hernia specialists and one plastics in the Boston area. I am in the Northeast US. All presented the same recommendation of total abdominal wall reconstruction with mesh, and said it was not something that would be an emergency need in regards to another bowel obstruction as a result of this hernia.
Early 2018 I was doing a situp and felt intense pain rip across the scar area. There was no warning sign. It’s been sore ever since. The pain has given way to more of a chronic ache/weak feeling as my conditioning has really slipped away as I’ve been babying it.
I have not heard of robotic surgery – thanks for mentioning that! I’ll look into it.
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I had a hernia in a similar location, mine was an umbilical hernia. Only two cm, but caused a lot of discomfort tbh. I can imagine how a five cm hernia feels. If it bothers you, it’s best to get it repaired with abdominal wall reconstruction since it’s starting to get in the “large” state as far as a size.
Good thing about today’s world is you can now get abdominal wall reconstruction done robotically, instead of having such a large incision done. Surgeons like Dr. Yuri Novitsky (NYC) and Dr. Igor Belyansky (Maryland) are two world renowned surgeons who have mastered the procedure using robotic surgery. Really is quite interesting. You can look up Dr. Belyansky’s robotic AWR videos on his YouTube page to get an idea of what it’s all about. Obviously, traveling for surgery isn’t easy. So if you can’t make it to them, it’s still important to find someone who’s close to you that is experienced with AWR.
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You’re doing things right by collecting as much information as you can, from varied sources. You can either keep learning until you feel confident in a path forward or find a surgeon that you really trust. Your description is somewhat vague and glosses over some important points. You’re only 38 and you’ve already had two open abdominal surgeries. So, much damage has already been done, which is probably why the “doctors” are suggesting abdominal wall reconstruction. And you haven’t supplied any details of what was done in those surgeries, just the fact you now have what appears to be a ventral hernia. More detail about what was done and the time it took to rehab from those surgeries might help with your decision.
Also, it’s not clear if the doctors you’ve talked to are surgeons who specialize in this field or if they are general practitioners who are not experts, and are just guessing. Make sure that you talk to some true experienced experts in the field.
Post your general location and people might have suggestions. For example, in the Northwest there is Dr. Martindale at OHSU. Members of this forum have had abdominal wall reconstruction by him
While you’re learning you should get ready for surgery. They’re calling it “prehabilitaton”. Good luck.
https://www.ncbi.nlm.nih.gov/pubmed/30138261
https://www.ohsu.edu/people/robert-g-martindale/332DF38FFB324681949B3E75BD3B492B
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