Soft bulge at my belly button three months after keyhole gallbladder removal, bigger when I cough. Is that a hernia, and is it urgent?

Keyhole gallbladder removal in July, all very routine, home the next morning, back at work in a fortnight. Three months on and I was doing up my jeans this evening and found a soft lump right in the belly button scar. About the size of a grape. When I cough it pushes out more, and when I lie flat on the bed it more or less disappears.

It does not hurt. It is just there, and I cannot stop poking it. I have been lifting my grandson a lot since the summer holidays, he is two and solid, and I am wondering if I have done this to myself.

Is this a hernia? Do I need to go to A&E tonight or can it wait for the GP?

Not a doctor, but a friend of mine had exactly that after his gallbladder op, grape at the belly button, came and went. It was a small hernia, he had it fixed as a day case and was back at work in a week. His went the GP route, not A&E. If it is soft and goes back in and does not hurt I would ring the GP in the morning.

My navel cut was the slow one too and for a few weeks I had a firm lump under it which turned out to be just healing tissue, it went by itself. But three months later and changing with coughing sounds different from what I had. Get it looked at.

Saw the GP. She had me stand and cough and said it is very likely a small incisional hernia at the port site, and has referred me back to the surgeons. Not urgent, she said, but gave me a list of things to go to A&E for. She also said it is not because of my grandson, or not only, which made me feel a bit better.

Waiting list is apparently a few months. Should I stop lifting him in the meantime? And is it going to get bigger?

I am the surgical moderator here. I cannot examine you, so I cannot say what you have or what you should avoid; that belongs with your GP and the surgeons you have been referred to. But I can explain what a port-site hernia is and what the warning signs are, which is what most people in your position want while they wait.

A port-site hernia is a bulge at one of the keyhole cuts, usually the belly button, where the firm layer of the tummy wall under the skin has not fully knitted back together, so fatty tissue can push through the gap. The belly button is the usual place because it is the largest port and is often where the gallbladder is taken out. The soft lump that grows on coughing and flattens when you lie down, which you describe, is the classic pattern. Studies give very different rates depending on how hard they look: one large hospital series found about 0.2%, a Dutch series of nearly 2,400 operations found 2.1% needed repair, and when CT scans were reviewed in one US study, far more turned up. Recognised risk factors include obesity, diabetes, wound infection, a longer operation, removal through the belly button, and a pre-existing separation of the stomach muscles. Lifting a toddler is not on that list as a cause, though straining can make an existing hernia more noticeable.

Whether it will grow, and whether to change what you lift while you wait, are good questions for the surgical clinic, and it is reasonable to ring them and ask if the wait is long.

The part that matters most while you wait: a hernia that becomes hard, painful and will not go back in, especially with vomiting, a swollen tummy, or not being able to pass wind or open your bowels, needs urgent help the same day, because bowel can occasionally get trapped. A soft painless lump that goes back is not in that category. Bridget has written this up, including what repair involves, at port-site hernias after gallbladder surgery.

Thank you, that is exactly what I needed and it matches what the GP said. Rang the surgical secretary on Friday, they said to keep lifting sensibly and ring back if anything on the list happens. Grandson informed he is walking to the car from now on. He disagrees.