[Kateballyheigue]

Hernia Surgeon

Thank you both for your replies and yes the information is very helpful. Your comment that everyone still has the umbilical remnant led me to look into this further and I found the following statement which, if I’m understanding correctly, is saying that it’s not the urachus that is obliterated, it is the connections (“communications”) that are usually obliterated:

Umbilical anomalies.
Griffith GL, Mulcahy JJ, McRoberts JW.
Abstract

During intrauterine development the primordia of the developing gastrointestinal and urinary tract come into close proximity in the umbilicus where the communication of these structures with the external environment is usually obliterated. In a small percentage of patients the omphalomesenteric duct and/or urachus may remain completely or partially patent. When complete patency is present, drainage of mucus, stool, or urine may occur. Partial patency may be manifest by an abdominal mass or by no symptoms at all. Definitive treatment includes total excision of the omphalomesenteric duct and/or urachus, lest recanalization of remnant tissue or carcinoma in later life occur.

http://www.ncbi.nlm.nih.gov/pubmed/472824

It’s interesting this quote also mentions “recanalization” because I believe he used that term or something similar to describe what may exist.

So perhaps he is just being cautious in suggesting avoiding that area, I’m not sure, but will ask about this on Friday. Or perhaps since I mentioned my reluctance to have this done laparoscopically after having heard it’s often done thru the belly button (for me a horrible thought!)

One other question/concern, if the port for the camera is going to be above the navel, and the umbilical hernia is being fixed with open, do you think having 2 holes so close together could be a potential issue? Since the umbilical is considered very small (the CT scan report says “tiny”) maybe I should just not have it done at all (it doesn’t bother me at all).

Dr Goldstein, I did check and yes you are about 2 hours from me so that may be a possibility. I’ll see how this next appointment works out first. This surgeon has done about 2500 of these so thankfully he is past the 250 – 500 Dr Towfigh mentioned is needed in another post (due to the steep learning curve of lap hernia surgery). But since there is always that small risk of chronic pain I do want to make sure I select a very skilled surgeon.

Thanks again for your help.