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Is Belly Button Protrusion Normal After An Umbilac Repain?

Posted on Mon, 21 Jul 2014

Question: I had a lap chole. The surgeon recommended repair of a very small non-systematic umbilical hernia because he had to enter via the belly button … but he entered via a smile incision ½ inch below the belly button. Why go mess with something that has never been an issue when he could have clearly done the lap chole without involving the belly button. Now my 1.5 cm deep belly button is inverted and protrudes outside the skin like something is pushing it from the inside. Is this typical with a umbilical repair? Can whatever is under it be removed? Can the belly button be restored to its natural state? How? What is such a procedure called?

Answered by Dr. Deepak Kishore Kaltari (45 minutes later)

Brief Answer:
Ubilicus port is usually used

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day,

Dear Sir,

Usually the Camera port or 10 mm cannula is inserted through the site of Umbilicus. As you had umbilical hernia, sub-umbilical smiley incision is necessary. It will also help i repairing the hernia through the same site
When the umbilical port site is closed, a suture is taken from the inner surface of skin of umbilicus to deeper structure, creating a normal looking umbilicus. Not taking this stitch will cause the skin to roll out, as if the skin is bulging outward. If the hernia is repaired well there is no cause for concern.
For cosmetic purpose it can be repaired by Umbilicoplasty which is a minor surgical procedure.

Do get back to me if you need any further assistance, will be glad to assist you.

Take Care

Best Regards
Dr Deepak Kishore
MBBS,MS,MCh
Consultant Surgeon

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Deepak Kishore Kaltari (51 minutes later)

If the lap chole can be done without entry into the umbilicus, then why was the umbilicus hernia repaired at all? I thought the reason why the very small non-systematic hernia had to be repaired was that the lap chole required the surgeon to go through the umbilicus?

Answered by Dr. Deepak Kishore Kaltari (5 minutes later)

Brief Answer:
Umbilical port is required

Detailed Answer:
Hi
Greetings

Umbilical port is preferred site for entering abdomen: It is through which Pneumoperitoneum is created and is the port for camera. If umbilical hernia is present, it is repaired in the same procedure, no matter how small the hernia is. During the closure of umbilical port , repair of hernia is achieved.

I hope i have cleared your doubts.

Take Care

Regards
Dr Deepak

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Deepak Kishore Kaltari (1 hour later)

I think I was unclear. Could the Lap Chole be done without interfering with the umbilical? As my incision is a sub-umbilical smiley incision rather than access via the umbilical ... it seems the surgeon had to go out of his way to repair the tiny umbilical hernia. I was told that the Lap Chole could only be accomplished with the repair of the umbilical hernia as that was allegedly the enter/exit point. Obviously it was not the entry/exit point.

Answered by Dr. Deepak Kishore Kaltari (12 minutes later)

Brief Answer:
Usually sub-umbilical incision is preferred

Detailed Answer:
Hi
Greetings

Technically it is easy entering by sub-umbical incision, so many of surgeons prefer sub-umbilical incision. Through the same sub umbilical incision , repair of umbilical hernia can be achieved. Umbilicus is a scar tissue of umbilical cord, technically it is difficulty cutting through it and entering the peritoneal cavity to gain access into the abdominal cavity. Also as there is umbilical hernia, entering directly through it may injury the underlying viscera.Even I personally use sub-umbical smiley incision for access.

I hope its clear now.
If you still have any doubts, kindly get back to me.

Take Care

Best Regards
Dr Deepak

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Deepak Kishore Kaltari (17 minutes later)

Could the lap chole have been done without involving the umbilical or was the hernia repair required to accomplish the lap chole?

Answered by Dr. Deepak Kishore Kaltari (6 minutes later)

Brief Answer:
Umbilicus is absoultely necessary port site

Detailed Answer:
Hi
Dear Sir

As I mentioned for the convenience of laparoscopic ergonomics, umbilicus is the preferred site for insertion of 1st port to create Pneumperitoneum( by instillation of carbon dioxide) and its use for inserting camera and visualization of gall bladder. As sub-umbilical port is used, majority of Surgeons repair the umbilical hernia if present. It avoids future surgery for umbilical hernia. Repair of umbilical hernia is important to prevent port site complication and also avoid further additional surgery in the possibility of hernia to enlarge.

Do get back to me if you need any further assistance, will be glad to assist you.

Take Care

Best Regards
Dr Deepak

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (39 minutes later)

So I understand you to say that I could have had the lap child without repair of the umbilical hernia. Correct? I further understand the the umbilical hernia repair was to prevent a possible hernia issue that could or could not have occur at some point in the future. Correct?

Answered by Dr. Deepak Kishore Kaltari (22 minutes later)

Brief Answer:
It's recommended ideal procedure

Detailed Answer:
Hi
Greetings
Dear Sir

Your understanding is partially right. Not only to prevent future complications, when a local pathology is found its important for the surgeon to inform the patient and try to correct it at the same surgical procedure.
One Surgery addresses both issues.

So it is recommended ideal procedure.

Take care

Best regards
Dr Deepak

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (23 hours later)

Thanks for your reply. Until my Lap Chole/umbilical hernia I was a very health and fit 47 year old male. My surgeon recommended the repair of a 3 mm non-systematic congenital umbilical hernia as part of my Lap Chole. He advised that the umbilical hernia repair was required to achieve the Lap Chole which I now understand was untruthful. The Lap Chole was uneventful but I have experienced significant issues from the umbilical hernia repair including much pain, a protruding umbilicus, two extra weeks out of work so far and two ER visits. The latest CT indicates I will require additional general surgery next week to repair the umbilical hernia repair. I am considering appropriate action for malpractice. I would highly recommend anyone to avoid the correction of non-systematic issues such as my umbilical hernia as "preventative procedures" secondary to a needed procedure such as my Lap Chole. If it's not broken ... I believe surgeons should leave it alone rather than risk such complications as I have experienced.

Answered by Dr. Deepak Kishore Kaltari (10 hours later)

Brief Answer:
Take care

Detailed Answer:
Hi
Greetings
Dear Sir,

I sympathise with all the problems you underwent.
Wishing you a very happy and healthy life.

I would also draw your notice towards many of the articles published in leading journals , where Surgeons usually tackle the coincidentally diagnosed umbilical hernia which is repaired during laparoscopic procedure done for other causes.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/

Do get back to me for any further discussion.

Take care

Best regards
Dr Deepak

Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar