Epigastric Hernia Surgery for Children: Procedure, Recovery, and Aftercare
What is Epigastric Hernia Surgery?
Epigastric hernia surgery is a procedure used to repair a hernia that occurs in the area between the umbilicus (belly button) and the rib cage, called the epigastrium. The small hole in the muscle often has a small piece of fat bulging through. This is either removed or pushed back in, and the defect is repaired with dissolvable stitches. It is rare for the fat bulge to get stuck. In children, the surgery is generally quick and highly effective, with a smooth recovery process for most patients.
Surgical Repair for Epigastric Hernia in Children
Epigastric hernia surgery is a day procedure performed under general anaesthetic. The surgeon makes a small cut just over the bulge and repairs the hernia using dissolvable stitches to close the opening. Mesh is not used in paediatric hernia repairs, which can be different to surgical repairs of adult hernias.
Not all children with epigastric hernias require surgery, even though they do not get better on their own. The chance of developing a problem from the hernia is very low throughout life.
If the hernia causes pain, then repair is worthwhile.
The wound is closed using dissolvable sutures, meaning there are no stitches to remove later. After the procedure, your child will be in the recovery room for monitoring, and you will be able to join them shortly after they wake up.
How Long Does the Operation Take?
The surgery itself takes around 15-20 minutes, but the overall process, including anaesthetic time, and waking up in recovery, will last around an hour.
You will be away from your child for about an hour until they are ready to be seen in the recovery room.
You’ll be notified just as they are waking up so you can be with them as early as possible.
What Are the Risks of the Operation?
Like any operation, epigastric hernia repair comes with some risks. However, the surgery is straightforward and serious complications are very rare.
- Anaesthetic Risks: Airway and breathing issues are extremely rare.
- Infection: The risk of infection is around 1%.
- Recurrence: There is about a 1% chance of the hernia coming back.
- Bleeding, Bruising, and Swelling: These are common minor side effects of surgery and typically resolve without issue.
What to Expect After Surgery
Once the surgery is complete, your child will be taken to the recovery room. You will be able to join them shortly after they wake up. Most children recover quickly from anaesthesia, and you will be able to give your child a feed in the recovery room once they are fully awake and hungry.
Your child can usually go home with you about an hour or two after surgery, once the nursing team ensures they are comfortable and safe.
Caring for the Wound and Dressings
After surgery, there will be a waterproof dressing over the incision site in the epigastrium.
The area may become a bit swollen or firm, which is a normal part of the healing process as scar tissue forms.
The scar will initially appear dark red but will fade over time.
Removing the Dressing: The dressing can be removed in the bath or shower after one week.
Bruising and Swelling: It is normal to see some bruising and swelling around the incision site. This should improve within a few days.
Pain Relief After Surgery
Your child will receive good pain relief during the operation, and this should last for a few hours afterward. Once at home, you may need to give your child paracetamol (e.g., Panadol) and possibly ibuprofen (e.g., Nurofen) for a few days. Please let your surgeon and anaesthetist know if your child has intolerances or allergies to particular medications.
It’s also helpful to distract your child and keep their mind off the surgery site. Activities like reading, playing board games, or other quiet, engaging tasks can help ease discomfort and take their mind off the area.
When Can My Child Return to Normal Activities?
Your child can return to normal daily activities fairly quickly after surgery, but some restrictions will apply:
- Bath or Shower: The day after surgery.
- Swimming: After one week.
- Daycare/School: Usually within 5-7 days.
- Sports or Physical Activity: After 2-3 weeks.
Troubleshooting Common Concerns After Surgery
Is there a wound infection?
Infections are uncommon but can occur 2-4 days after surgery. Signs of infection include:
- Increased redness or tenderness around the wound.
- Discharge from the wound site.
- Fever or general unwellness.
If you notice these signs, contact your paediatric surgeon or family doctor for further advice.
It is very swollen – Has the hernia recurred?
Some swelling is normal after surgery, but if your child experiences increasing pain, tenderness, or vomiting, this could be a sign of recurrence. If the symptoms resemble those from before the operation, call your surgeon or visit your GP to have your child assessed. If your child is unwell, seek emergency care.
After surgery, what symptoms might be cause for concern?
You know your child best, and if something doesn’t seem right, it’s always best to seek advice. Here are some key symptoms that require medical attention:
- Increasing pain or pain that doesn’t improve with pain relief.
- A new or increasing bulge in the groin area.
- Fever over 38.2°C.
- Vomiting or trouble feeding.
- No bowel movements after three days.
- Any discharge or bleeding from the wound.
If you notice any of these symptoms, contact your surgeon or family doctor.
Frequently Asked Questions (FAQs) About Umbilical Hernia Surgery in Children
Does my child need surgery for an epigastric hernia?
Not always. Epigastric hernias require surgical repair to reduce the bulge, pain or prevent complications such as the fat bulge getting stuck. This is uncommon. Your paediatric surgeon will discuss the best timing for the surgery.
How long does the surgery take?
The surgery itself typically lasts about 15-20 minutes. However, including anaesthetic and recovery time, the entire process will take around an hour. You will be able to see your child in the recovery room once they wake up.
Is epigastric hernia surgery safe for children?
Yes, epigastric hernia repair is a common and straightforward procedure in children. The surgery is performed under general anaesthetic, and the risk of serious complications is extremely low.
Will my child be in pain after surgery?
Your child will receive pain relief during the surgery, and most children experience only mild discomfort afterward. Over-the-counter pain relief like paracetamol or ibuprofen can help manage any post-surgery discomfort.
How long will it take for my child to recover?
Most children recover quickly and can return to normal activities, such as bathing and school, within a week. Sports and other physical activities may need to be avoided for 2-3 weeks.
What should I do if my child has a fever or is in pain after surgery?
If your child’s fever exceeds 38.2°C or they are experiencing increasing pain that doesn’t improve with pain relief, contact your paediatric surgeon or family doctor for further advice.
What are the signs of a wound infection?
Signs of a wound infection include redness, tenderness, or discharge from the wound. If you notice these symptoms or your child is feeling unwell, contact your paediatric surgeon or GP immediately.
What should I do if the hernia comes back?
While recurrence is rare (about 1% of cases), it can happen. If you notice a new or increasing bulge at the surgery site or your child is experiencing pain and vomiting, contact your surgeon to have it assessed.
When should I seek emergency medical attention?
You should seek emergency care if your child is experiencing any of the following:
- Persistent or increasing pain despite pain relief.
- A new or increasing bulge in the umbilicus.
- Fever over 38.2°C.
- Vomiting or difficulty feeding.
- No bowel movements for more than 3 days.
- Discharge or bleeding from the wound.
Learn More About Epigastric Hernia
Visit our page on Epigastric Hernia for more detailed information.
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