Hii Abraham, i have gone through your question and understand your concerns regarding surgery. Umbilical hernia is quite common in elderly age group. Tab. Hepexa is a temporary medication it cannot be substituted with surgery. smaller hernias without symptoms can sometimes be watched but if the hernia is not getting smaller while lying down or cannot be pushed back in, surgery is usually preferred. without surgery, sometimes in larger hernias, there is a risk of intestines getting stuck and blood supply getting cut off (strangulation). in these cases surgery is a must. I understand your concern in your grandmother s health owing to her age. but hernias now a days can be repaired using a laparoscope, a thin, lighted tube that lets the doctor see inside one s belly. it can be done under general anaesthesia. risks of surgery are usually vey low unless patient has a serious medical problem. I would suggest you to carefully weigh the options and consult a surgeon who would provide you the exact procedure details. hope my answer helped. wish your grandmother a good health.