UMBILICAL HERNIAS

UMBILICAL Hernias, and nearby hernias called "Paraumbilical Hernias" develop in and around the area of the umbilicus (belly button or navel). A congenital weakness (meaning present since birth) exists in the naval area in the region where vessels of the fetal and infant umbilical cord exited through the muscle of the abdominal wall. After birth, although the umbilical cord disappears (leaving just the dimpled belly-button scar), the weakness in the muscle may persist. Hernias can occur in this area of weakness at any time from birth through late adulthood. As the weakness progressively bulges and opens, abdominal contents are permitted to protrude through. In addition to the navel deformity and an associated bulge, the signs and symptoms include pain at or near the navel area. The hernia bulge pushes out upon the skin directly at or around the navel, distorting the normal contour and architecture, creating an 'OUTIE' instead of a normal 'INNIE' navel.
Although often appearing at or just after birth, these hernias can also occur at any time during later life. In INFANTS, these hernias most often gradually close by age 3 or 4, and surgery can often be delayed until that time. If however, these pediatric umbilical hernias are causing problems or enlarging, surgery can be recommended earlier. This decision for surgery should only be made after a comprehensive examination by a Pediatrician or skilled Surgeon.
In adults however, umbilical hernias cannot "heal" and gradually increase in size, often becoming progressively problematic as they enlarge. Incarceration or Strangulation may occur on the occasion of large and neglected Umbilical Hernias.

Optimally, umbilical hernias should be repaired using a

Umbilical hernias often occur in adulthood because of progressive and significant tension on the congenital area of weakness beneath the navel. This develops through the normal stresses and strains of daily activity. Standard techniques still widely utilized today attempt to repair these hernias by simply closing the muscle defect with sutures placing the muscle tissue under significant tension. Often in these older method repair techniques, muscle layers are overlapped creating even more tension. Such suturing not only recreates the muscle layer tension that originally created the hernia defect, but too often this process also weakens adjacent tissue layers as well. Moreover, this leads to unnecessary pulling of the tissues at the hernia area. We recognize surgically that any tension on sutured muscles inhibits normal healing and causes swelling, pain and prolonged recuperation. These older suture-only techniques have been shown to be significantly less effective than Tension Free mesh repairs with a much higher recurrent hernia rate later on.

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THE RESULT OF HERNIAS REPAIRED WITH TENSION
Excessively prolonged recovery, and more importantly a high risk of recurrence. This need not be the case any longer !

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At The NORTH PENN HERNIA INSTITUTE, our Surgical Staff is now fully trained to repair these hernias effectively in a TENSION FREE fashion, most often as a "One Day" procedure. This contemporary surgical technique is usually performed with mild sedation and local anesthesia, thus avoiding the risks of General Anesthesia. In Umbilical Hernias in adults, especially large and recurrent Umbilical Hernias, a Mesh is utilized to created a 'Tension Free' repair. The mesh is carefully opened "BELOW" (never on over) the defect, extending somewhat beyond the under edges of the hernia 'hole' itself. This immediately, safely and securely repairs the hernia. In addition, the mesh acts as a bridge or scaffolding for in-growth of new tissue to broadly support the abdominal wall muscle. In the process, the mesh safely becomes incorporated into the muscle layer. No muscle is cut, nor is it ever sutured together to create unnecessary or unwanted TENSION. The surgical mesh utilized for hernia repair is extremely thin and very flexible. Therefore it is undetectable to the patient both during normal day to day activity as well as during more aggressive physical and recreational activity. However, it is strong enough to fully and effectively repair the hernia such that our patients are fully able to resume NORMAL ACTIVITY without undue concern for recurrence. Plastic Surgery skin closure techniques are always utilized on Umbilical Hernias as it is in all of our hernia incisions. The desired cosmetic concave appearance of the umbilicus or navel returns to normal after surgery and the navel is NOT removed nor altered.
Patients are discharged on the same day as surgery.

Return to NORMAL ACTIVITY in Days!!

215-368-1122

Surgery is performed at
THE CENTRAL MONTGOMERY MEDICAL CENTER
Outpatient Surgery Department
(Formerly North Penn Hospital)
in Lansdale, Pennsylvania

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FROM: James A. Goodyear,M.D., F.A.C.S. NORTH PENN HERNIA INSTITUTE 2100 North Broad Street, Suite 100 Lansdale, PA 19446 215-368-1122 Hello, Thank You for visiting our site. Our mini-incision TENSION FREE procedure for Umbilical Hernias is done as an outpatient using mild sedation and local anesthesia (ie: Novacaine-like medication). Our patients are discharged shortly after the repair with minimal discomfort and virtually NO RESTRICTIONS. They can actually RETURN TO NORMAL ACTIVITY in 1-2 days including driving, work and even many sports activities. Umbilical hernias are the second most common surgically treated hernias. They result from a defect or opening in the abdominal wall muscle directly beneath the umbilicus. As a result, the contents of the abdomen, including possibly the intestine, will protrude through this opening or defect creating a bulge at the umbilicus or navel. Generally, with time, these hernias enlarge, and may become problematic and painful. If intestine becomes trapped within the hernia, an emergency situation exists and urgent surgery is needed. The surgery for UMBILICAL HERNIAS is rather straight-forward. At the North Penn Hernia Institute, surgery is generally performed SAFELY as an outpatient under local anesthesia, with sedation. Through a very small incision, generally just below the umbilicus, the abdominal contents are returned to there normal position, and the defect or opening securely closed via a tension free mesh technique. Mesh is used in these procedures in adults to permit a "Tension Free" repair with a resultant rapid recovery post-operatively. Recurrence is extremely extremely rare. Repairs not using mesh, as was the standard in the past, and is frequently still performed in many areas are associated with a high rate of subsequent larger and more complex recurrent hernias. This is why we avoid tension in our repairs. Patients at the NORTH PENN HERNIA INSTITUTE are discharged shortly after surgery with minimal discomfort. Restrictions place on activity are few thus allowing return to Normal Activity in DAYS!! This also permits a rapid return to work and recreational activity as well. We fully feel that our technique is not only the safest procedure available, but also associated with the least post-operative discomfort, most rapid return to normal activity and is associated with the lowest rate of recurrence when compared to the other techniques. We evaluate fully the anatomy of the hernia at the time of surgery. We strongly feel that a single operatve technique is not necessarily suited for all hernias but that hernias may and often do vary significantly from patient to patient. We therefore use our experience and expertise to tailor our TENSION FREE surgical procedure to always provide our patients with a repair that is precisely customized to their particular hernia needs, and is the very best (Safest and most Effective) surgery for them. IF YOU CARE TO SPEAK TO ME DIRECTLY BY PHONE (free!!), PLEASE COMPLETE THE FORM AT: PHONE CONSULTATION I WILL BE HAPPY TO SPEAK WITH YOU PERSONALLY. OR CALL OUR OFFICE AT: (215-368-1122) Hernia Surgery is one of the most common surgical procedures over 900,000 hernia repairs being performed annually. At the NORTH PENN HERNIA INSTITUTE, our surgeons, who are all Hernia Specialists perform hundreds of Hernia operations each year with over 1000 anticipated in 2004. While general surgeons often do hernia surgery as a small part of their large and busy practice, we firmly believe that the HERNIA SPECIALISTS offer their patients the safest and most effective surgical procedure available. At North Penn Hernia Institute, our experience with both routine and complex Umbilical Hernias is extensive. The majority of our patients have surgery under local anesthesia, with sedation and are comfortably free of pain, including those having UMBILICAL HERNIA REPAIR. This avoids the added risks associated with general anesthesia (being put to sleep). In addition, since our patients are awake, they are up and "ambulatory", virtually pain free, shortly after surgery, and are discharged home usually within 1-2 hours, on the "Same Day". FREE ON LINE CONSULTATION Thank You for visiting our site, and BEST OF LUCK to you!!! If you would consider having your hernia repaired here at the North Penn Hernia Institute, please feel free to contact us at : 215-368-1122 (M-F 9:00-4:30) We would be happy to participate in your care. Surgery can be arranged on the same day as your initial consultation and examination to minimize your travel. Directions and local lodging availability can also be obtained through our office. WE HOPE TO HEAR FROM YOU!! James A. Goodyear, M.D., F.A.C.S. Director and Staff Surgeon North Penn Hernia Institute 215-368-1122 E MAIL Us

Surgery is performed at

formerly
NORTH PENN HOSPITAL
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in Lansdale, Pennsylvania