Incisional Hernia

An incisional hernia happens when a weakness in the muscle of the abdomen allows the tissues of the abdomen to protrude through the muscle. 

Incisional hernias occur when the surgical incision in the abdominal wall after the surgery does not heal or close properly. 

The irreducible hernias can be treated only with surgery. The doctor will decide depending on various factors for either an open repair surgery or a laparoscopic surgery.

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What is an Incisional Hernia?

Incisional hernias develop in 15 -20 percent of the cases after abdominal surgery. There are numerous factors that are responsible for the increase or decrease in the risk associated with developing incisional hernias.

Causes of Incisional Hernia

Incisional hernias occur when the surgical incision in the abdominal wall after the surgery does not heal or close properly. Thus, the abdominal muscles weaken and the internal tissues and/ or organs push through the weakened muscle to form a hernia. 

Factors responsible for improper healing, leading to hernia formation are:

  • Resuming physical activities too soon after the abdominal surgery.
  • In women, getting pregnant before the expected time of healing of the surgical wound.
  • More likely to form in emergency or surgeries requiring a large incision.
  • The chances increase with improper suturing if the edges of the wound are not aligned well.
  • The suturing technique could also be responsible.

Occasionally there is no specific reason that can be determined for the formation of the hernia.

Symptoms of Incisional Hernia

A protrusion at the surgery site is the visible symptom of an incisional hernia. An incisional hernia is most likely to develop between three to six months of the surgery, but there are cases of it developing before or after as well.

There are two types of physical symptoms:

Reducible hernia: Protruding tissue can be pushed back to its position. Or, the hernia reduces in size while the patient is in the lying down position.

Irreducible hernia: The intestine pushes into the weakened repaired abdominal muscle wall, which cannot be easily pushed back into position. It could lead to bowel obstruction, followed by strangulated hernia which requires immediate medical attention.

Discoloration of the bulge of the hernia also indicates immediate medical attention. Severe cases of incisional hernia may present the following symptoms along with the bulge:

  • ​An ache or burn around the hernia.
  • Fever
  • Nausea and vomiting.
  • Abdominal pain and discomfort radiating from the hernia.
  • Increased heart rate.
  • Diarrhea
  • Constipation
  • Narrow or thin stools being formed.

Diagnosis for Incisional Hernia

The diagnoses begin with a physical examination of the hernia. If the hernia causes slight or no discomfort, the doctor may keep the patient under observation.

 Although, surgery at the stage where the hernia is small in size is less complex than for larger hernias. The doctor may recommend a special belt to keep the hernia in place.

Treatment options for Incisional Hernia

The irreducible hernias can be treated only with surgery. The doctor will decide depending on various factors for either an open repair surgery or a laparoscopic surgery. 

The surgery is to push back the protruding tissue or organ into its position and suturing the abdominal wall, reinforcing it with a mesh and suturing the incisional wound. 

Laparoscopic surgery is a minimally invasive surgery, which allows early recovery and discharge of the patient.

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