Mr Trif Papettas FRCS

Umbilical & Incisional Hernia Repair in Warwickshire

A bulge at the belly button or along an old surgical scar is one of the most common reasons patients are referred for a hernia opinion. Here is how these two hernia types differ and how they are repaired.

Medically reviewed by Mr Trif Papettas FRCS, Consultant Colorectal & General Surgeon  ·  Last reviewed 2026-08-20  ·  Nuffield Health Warwickshire Hospital, Leamington Spa

Umbilical and incisional hernias are grouped together because both occur through the front of the abdominal wall, rather than the groin, and both are typically repaired with similar surgical principles — but they arise for different reasons and vary considerably in size and complexity.

Umbilical Hernias

An umbilical hernia appears as a bulge at or near the belly button. It is especially common after pregnancy, with abdominal weight gain, or simply as a feature of ageing tissue. Many are small and cause only mild discomfort; others enlarge over time and become more symptomatic, particularly with lifting or prolonged standing.

Incisional Hernias

An incisional hernia develops through a weakness along a previous surgical scar — anywhere from an old appendix or gallbladder incision to a caesarean section or major abdominal surgery scar. These can range from small and easily managed to large, complex defects, particularly after multiple previous operations, and the repair strategy is planned individually based on imaging (usually CT or ultrasound) and examination.

FeatureUmbilical HerniaIncisional Hernia
Typical causeNatural weak point at the navel; pregnancy, weight gain, ageingIncomplete healing along a previous surgical scar
Typical sizeUsually small to moderateRanges widely — small to large/complex
Common repairSuture or mesh, open or keyholeMesh reinforcement, open, keyhole or robotic depending on size
RecoveryDays to 1–2 weeks1–2 weeks (small) to 6–8 weeks (large/complex)

Mesh & Repair Technique

Most umbilical and incisional hernias are reinforced with mesh to reduce the chance of recurrence, with the exception of very small umbilical defects. Where feasible, a keyhole or robotic-assisted approach is used to place mesh behind the muscle layer through small incisions — this is particularly useful for incisional hernias where the original scar tissue is best left undisturbed. Larger or more complex defects, including those with loss of abdominal domain, may need a planned open repair with component separation techniques. Read more about the robotic option on our robotic hernia repair page.

What to Expect

  1. Initial consultation and clinical examination, often supported by ultrasound or CT imaging to size the defect and plan the repair.
  2. Day case or short-stay admission at Nuffield Health Warwickshire Hospital, Leamington Spa, depending on complexity.
  3. Individually tailored aftercare plan, including activity restrictions specific to the size of the repair.
  4. Follow-up review to confirm healing and safe return to full physical activity.

Why Choose Mr Trif Papettas

8,000+Procedures Performed
95%Keyhole Rate
<5%Conversion to Open
0%Elective Mortality
Complex and recurrent hernias are a particular area of interest — every repair plan is built around your specific defect, previous surgical history, and goals, not a one-size-fits-all protocol.

Book a Hernia Consultation

Whether your hernia has been there since pregnancy, appeared after weight change, or developed along a previous surgical scar, a consultation with Mr Papettas will clarify the size and type of repair that suits it best.

Self-pay and all major insurers accepted. Appointments available at Nuffield Health Warwickshire Hospital, Leamington Spa, serving Leamington Spa, Warwick, Kenilworth, Stratford-upon-Avon, Coventry, Solihull and across Warwickshire.

Call 01926 935121 to Book

Frequently Asked Questions

What causes an umbilical hernia in adults?

The umbilicus (belly button) is a natural weak point in the abdominal wall where the muscle never fully closes over in some adults. Umbilical hernias are common after pregnancy, with significant weight gain, with long-standing abdominal straining, or simply with age as the surrounding tissue weakens. They present as a bulge at or just above the belly button, which may ache, particularly after standing for long periods or heavy lifting.

What is an incisional hernia, and why does it happen after surgery?

An incisional hernia develops when the muscle layer beneath a previous surgical incision doesn't heal fully, allowing tissue to push through along the scar. It can appear months or even years after the original operation, and risk is higher after wound infection, in patients who smoke, in those with diabetes, or after emergency surgery. It presents as a bulge along or beside the old scar, which may enlarge gradually over time.

Can these hernias be repaired without mesh?

Very small umbilical hernias (typically under 1–2cm) are sometimes repaired with sutures alone, but the majority of umbilical and virtually all incisional hernias are repaired with mesh reinforcement, because suture-only repair carries a materially higher recurrence rate, particularly for larger or incisional defects. The right approach depends on the size and location of the defect, discussed individually at consultation.

Is keyhole repair possible for incisional hernias?

Yes, in many cases. Laparoscopic or robotic-assisted repair can be used for a good proportion of incisional hernias, placing mesh from behind the muscle layer through small incisions rather than reopening the original scar. This is particularly valuable for patients with a history of wound infection, as it avoids operating through previously compromised tissue. Larger or more complex defects may still be better suited to an open approach — this is assessed on imaging and examination.

How long does recovery take?

This varies more with incisional hernias than with straightforward inguinal or umbilical repairs, because the size of the defect and the extent of previous scarring both matter. Small umbilical repairs are typically day case with a return to light duties within a week or two. Larger incisional repairs may involve a short overnight stay and a more gradual return to heavy activity over 6–8 weeks, which is discussed individually before surgery.

Will losing weight first help my repair?

For patients with a significantly raised BMI, optimising weight before elective hernia repair can reduce the risk of wound complications and recurrence, and this is something Mr Papettas will discuss openly and supportively where relevant. It is not always necessary, and is balanced against the hernia's size and symptoms — a case-by-case decision rather than a blanket rule.

Mr Trif Papettas FRCS

About Mr Trif Papettas FRCS

Consultant Colorectal & General Surgeon at Nuffield Health Warwickshire Hospital, Leamington Spa. FRCS; MB ChB with Honours and Distinction (Sheffield); Ethicon Advanced Laparoscopic Fellowship; JAG dual accreditation in colonoscopy and gastroscopy. 8,000+ procedures performed, with a 95% keyhole rate and a sub-5% conversion-to-open rate. Author of 19 peer-reviewed publications (146+ citations).

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