Incisional Hernia

What is a Incisional Hernia

An incisional hernia occurs at the site of a previous surgical incision in the abdominal wall. This type of hernia develops when the tissue pushes through a weakened area in the abdominal muscles, which can happen after any abdominal surgery. The hernia may present as a noticeable bulge under the skin and can be associated with discomfort or pain.

Causes of an Incisional Hernia

Incisional hernias are caused by the incomplete healing of the surgical incision, which can be due to several factors, including infection at the surgical site, excessive strain on the incision due to heavy lifting or vigorous activity, being overweight, poor nutrition, chronic coughing or sneezing and smoking.

Symptoms of an Incisional Hernia

Common symptoms of an incisional hernia are usually a visible bulge near the site of a previous surgical scar, discomfort or pain, especially when straining or lifting and a feeling of pressure or heaviness in the abdomen with or without tenderness at the site of the hernia. Most incisional hernias are diagnosed following clinical examination. Imaging of the hernia might be requested in the form of a CT scan of the abdomen to confirm the diagnosis, ensure no other sub clinical hernias are not present and to define the anatomy so treatment can be planned.

Treatment options for an Incisional Hernia

The gold standard treatment for incisional hernias is a surgical repair which can be done using an open technique or key hole surgery (laparoscopic). It may involve the use of a mesh or not. Your surgeon will discuss with you the best approach for your hernia and this usually depends in the size of the hernia defect, patient’s medical history and anatomical factors. Not all approaches in repairing an incisional hernia are appropriate for all patients. Our surgeons are experienced in both open and laparoscopic repair techniques for incisional hernias with or without the use of mesh.

Open Hernia Repair

An incision is made over the site of the hernia, The herniated tissue is carefully pushed back into the abdominal cavity. The surgeon then assesses the remaining defect on the abdominal wall and decides if the defect can be closed with no tension by directly suturing the two edges. Sometime the muscles of the abdominal wall might need to be released (known as component separation techniques) to allow this to be done with minimal tension. If indicated a synthetic mesh is placed to reinforce the weakened area of the abdominal wall and prevent recurrence. The incision is closed with sutures, staples, or surgical glue.

Laparoscopic Hernia Repair

Several small incisions are made in the abdomen and a laparoscope (a thin tube with a camera) and surgical instruments are inserted through these incisions. The hernia is pulled back into the abdomen using specialised tools. A synthetic mesh is placed to reinforce the abdominal wall from the inside and this is secured with sutures. The small incisions are closed with sutures or surgical tape.

Postoperative Care

Gradually resume normal activities as recommended by your surgeon. Avoid heavy lifting and strenuous activities for several weeks. Keep the surgical site clean and dry. You will be discharged with appropriate analgesia. In patients with larger hernia your surgeon might advise you wear an abdominal binder for about 6-12weeks after the operation to avoid accumulation of fluid (seroma) at the site of the hernia repair.

Conclusion

Incisional hernia repair, whether open or laparoscopic, is a critical intervention to prevent further complications and improve quality of life. Both methods have their unique benefits and drawbacks, and the choice of technique will depend on the specific circumstances of the hernia and the patient’s overall health. Please get in touch with our expert surgeons to discuss your concerns or symptom in regards to an incisional hernia. Our surgeons will assess you and advise you on the best approach to repair your incisional hernia.

Basingstoke Colorectal & Peritoneal
The Hampshire Clinic
Basing Road
Basingstoke RG24 7AL

Call us

01256 354747