Incisional hernia
An incisional hernia, also known as a ventral hernia, is a type of hernia that is caused by thinning or stretching of scar tissue that forms after surgery. Most commonly they occur at the site of a previous abdominal operation, commonly bowel or gynaecological surgery, although they can also occur following stomach or gallbladder surgery and even at the entry site used for key hole surgery, occuring as the result of up to 30% of major abdominal operations.
Incisional hernias are caused by thinning or stretching of scar tissue that forms after surgery. This weakened scar tissue then creates a weakness in the abdominal wall. The reason for this is that a long incision is made and the tissues are sutured together over an extensive area, made worse by any physical pressure that places pressure on the abdomen, including pregnancy, obesity and various abdominal illnesses.
An incisional hernia causes a bulge in the abdominal area. The bulge may disappear when lying down and be more visible when standing up. It may be reducible by pushing it gently back in place.
Symptoms can include pain, nausea, vomiting and inability to have a bowel movement. In some cases the incisional hernias will increase in size over time.
Whilst incisional hernias can be dealt with nonoperatively by wearing a belt and avoiding abdominal strain (etc), most patients prefer surgery to remove the hernia. The hernia can be repaired laparoscopically by pushing the piece of the organ back into place and repairing the abdominal wall so that the organ cannot push through again in what is termed a herniorrhaphy or it can be repaired by placing a small patch over the wound, which is called a hernioplasty.