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An incisional hernia is a type of hernia that develops at the site of a previous abdominal surgery incision. After surgery, the healing wound can weaken the connective tissue of the abdominal wall, allowing a portion of the intestine or fatty tissue to protrude through the abdominal wall. An incisional hernia may occur months or even years after the operation. It is estimated that about 1 in 10 abdominal surgeries may result in an incisional hernia.
Causes of Incisional Hernia
Chronic diseases such as anemia and diabetes
Collagen tissue disorders
Cancer
Chronic constipation
Working in jobs that require heavy physical effort
Heavy exercise
Chronic cough
Symptoms of Incisional Hernia
A swelling may appear at the previous surgery site when standing, coughing, or straining due to increased pressure inside the abdomen. Because these hernias can grow quickly, if they are noticed, they should be treated without delay.
Diagnosis of Incisional Hernia
Diagnosis is usually made by physical examination. However, in some cases, additional tests such as an abdominal ultrasound or computed tomography (CT) may be needed.
Treatment of Incisional Hernia
The treatment for an incisional hernia is surgical repair. Different surgical techniques have been defined for this type of hernia. In general, they are grouped into two main approaches: open surgery and laparoscopic (minimally invasive) surgery.
Open Surgery
Under general anesthesia (fully asleep) or spinal anesthesia (numbing from the waist down), an incision is made around the previous scar, the hernia sac is identified, and the contents are returned to the abdominal cavity. Depending on the size of the hernia, repair can be done with stitches or with special synthetic mesh.
Laparoscopic (Minimally Invasive) Surgery
The operation is performed using special instruments inserted through several small incisions in the abdomen. It can be safely applied even for large hernias. Because adhesions may be present in the abdomen, this method should be performed carefully. The incisions are smaller, pain is typically less, and return to normal life is generally faster.
Incisional Hernia FAQ
What happens if I don’t have incisional hernia surgery?
Intestines or other organs can protrude into the incision site. If they become trapped, the hernia can become strangulated. This may progress to loss of blood supply and bowel tissue damage, so treatment is recommended.
How long does incisional hernia surgery take?
On average, incisional hernia surgery takes about one hour for both open and laparoscopic (minimally invasive) techniques.
Can an incisional hernia cause gas?
An incisional hernia may cause abdominal pain and bloating. It can also lead to increased gas and, in some cases, difficulty passing stool.
Can an incisional hernia go away on its own?
No. An incisional hernia does not resolve spontaneously and cannot heal on its own. Surgical repair is required.
Will an incisional hernia get bigger?
If left untreated, an incisional hernia can grow over time. If not repaired properly, it may also recur.
