Umbilical Hernia & Robotic Repair

What is an umbilical hernia?

An umbilical hernia happens when tissue from inside your abdomen pushes through a weak spot in the abdominal wall at or near your navel. That tissue might be fat, the lining around your intestines (omentum), or in some cases a loop of intestine itself, creating a visible or feelable bulge.

Types of umbilical hernia

• Reducible: the bulge goes back in when gently pushed.
• Incarcerated: the bulge stays out, even with pressure.
• Strangulated: the blood supply to the trapped tissue is cut off. This is a surgical emergency, and if this is suspected, you'll be sent straight to the Emergency Department.
• Recurrent: a hernia that has been repaired before and has come back.

How robotic-assisted repair works

During robotic surgery, Dr. Rodriguez sits at a console and controls every instrument movement directly, while the surgical team stays at your side the entire time. The robotic system provides a high-definition, 3D view of the surgical area, allowing precise reconstruction through small incisions.

1. Anesthesia: you're fully asleep for the procedure.
2. Getting in: four small incisions are placed, giving good spacing and mechanical advantage for the instruments. Entry into the abdomen uses a direct-visualization technique (Optiview), chosen specifically to lower the risk of injuring anything underneath as the team enters.
3. Creating the working space: a pre-peritoneal space (just outside the abdominal lining) is created to work in, keeping the repair away from the intestines whenever possible.
4. Closing the defect: the hernia contents are brought back into the abdomen and the hernia defect is closed with sutures.
5. Reconstructing the navel: the navel is rebuilt as the hernia is closed, with careful attention to restoring a natural, inward-appearing navel whenever possible.
6. Placing mesh: if indicated based on defect size, mesh is measured, positioned with generous overlap around the defect, and secured.
7. Closing the working space: after the mesh is placed, the space created for the repair is closed.

Getting your body ready for surgery

• Quit smoking well before surgery and stay smoke-free during recovery. Smoking significantly raises the risk of wound problems, infection, and recurrence.
• Control blood sugar. For patients with diabetes, an A1C under 7% before elective surgery improves healing and lowers infection risk.
• Weight management and control of other chronic conditions may also be part of your prep.

Risks to know about

• Bleeding (usually minor)
• Infection of the incision or, rarely, the mesh
• Injury to intestines, blood vessels, or nerves during initial entry and during the dissection process. This risk is small, but does vary based on anatomy and scar tissue
• Hernia recurrence, even with proper technique
• Chronic pain, fluid collection (seroma), or scarring

Recovery: what to expect

• Wound care: incisions are closed under the skin with dissolvable stitches and a watertight purple surgical glue. You can shower the day of surgery; just pat dry. Do not submerge incisions in a pool, tub, or other body of water for at least 4 weeks. A compression dressing over the navel is usually removed the Sunday after surgery.
• Sun protection: avoid sun exposure on incisions for 6 months to prevent permanent discoloration.
• Pain control: scheduled Tylenol (acetaminophen), Celebrex (celecoxib), and Robaxin (methocarbamol) for the first 3 days, with a narcotic available for breakthrough pain only.
• Activity: walking is encouraged right away. Avoid lifting, pushing, or pulling more than 10–15 pounds for 4 weeks, and avoid core exercises during that time. You can drive again when no longer taking narcotic / sedating medications and you can quickly go from gas to brake pedal without pain inhibiting your movement.