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Umbilical hernia and gallstones
I have an umbilical hernia now from 6 years since my first pregnancy and while I was getting the size of it checked during an ultrasound they found two gallstones as well.
The size of the umbilical hernia is approximately 33.9 mm (transverse) x 23.3 mm (anteroposterior). The midline defect measures ~22.5 mm (craniocaudally) and 21.5 mm (transversely). The stone size is roughly 7 to 8 mm.
Now I may want to plan a second pregnancy in the future. I consulted a gynecologist and she mentioned that hernia is quite big and I should get it fixed urgently. She also routed me to a general surgeon and he mentioned that we should go for cholecystectomy and while he would be closing up during surgery he would stitch the hernia. Keeping the mesh surgery an option for future.
Now I am having doubts whether the stitches will hold for that size of hernia. And although I think I do not have any more options but I also want to understand how suture closing Impact the future pregnancy.
U can go for hernia mesh surgery and lap cholecystectomy in the same siting
Hernia can be nicely repaired using laparoscopy only
Chances of recurrence are next to nil if hernia repaired properly using mesh
IPOM is an option
TARM is an option
Next Steps
consult me or any surgeon who is handy with such surgeries
Health Tips
if u go into pregnancy with pre existing disease u might be in trouble later on
advisable to have ur ailments treated prior to conception
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The suggestion by the surgeon is correct. Consider gall bladder surgery with hernia repair. Suture closing has a higher risk of recurrence of hernia than mesh repair especially during conditions where abdomen pressure increases such as pregnancy, but neither a mesh nor suture repair can guarantee that a hernia won’t recur.
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Yr surgeon has given u a perfect option. It’s not that suture will affect pregnancy , but a second pregnancy will lead to high chances of recurrence in hernia and gallbladder should be operated before the pregnancy. So a Midway solution is to do a laparoscopic gall bladder surgery and close the hernia with suture, and in case case you have a recurrence in hernia post pregnancy, he can do a definitive job by putting a mesh.
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For a hernia repair, the chances of recurrence in the long term are always present, especially with an impending pregnancy that's being planned. The option given by your general surgeon seems good enough because if you go for a mesh repair and then the hernia recurs, it's difficult to go for a repair without removing the entire mesh again.
Next Steps
If postponing the pregnancy is an option and the hernia defect isn't very large, a laparoscopic removal of the gall bladder along with repair of the hernia with or without a mesh can be done. If the pregnancy planning is imminent, a gall bladder removal with closure of the hernial defect as advised is a good option
Health Tips
1. Physically go and consult a general surgeon
2. Do not lift heavy weights or do strenuous activity as it causes the hernia to increase in size
3. Watch for any signs of constipation, abdominal distension, vomitting or skin discoloration over the hernia
4. If the hernia is large in size, try to lose some weight before getting operated.
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