In adults, a painful and enlarged bulge is usually treated with surgery. Surgery can prevent further complications of the hernia which can occur due to strangulation.
However, in children, the hernia generally resolves by 18 months. Your doctor may wait for a while before suggesting surgery. Indications for recommending surgical repair in children include:
Your surgeon may perform either an open surgery or a keyhole surgery (laparoscopy) for repairing the umbilical hernia. Laparoscopy may be recommended if the hernia has reappeared after a prior surgery. Surgery can be performed under general or local anaesthesia. However, local anaesthesia is given to adults with small hernias and in whom general anaesthesia may not be safe.
Your surgeon will make a single incision of 2 to 3cm below the navel and push the protruded part into your abdomen. The weakened spot of the abdominal wall will then be stitched with sutures. In cases of large hernias, your surgeon may place a mesh patch for strengthening the weak abdominal wall. The skin will be sutured with dissolvable stitches and a dressing will be applied to the wounded area.
Your surgeon will make two to three small incisions away from the bulge and insert a laparoscope (a fibre-optic tube with a light source and camera attached to it) and other special instruments through the incisions. The bulge will be pushed into the abdominal cavity, and the abdominal wall will either be stitched or a mesh will be placed to support the weak part of your abdominal wall.