- Procedure Time
30-45 minutes - Anaesthesia
Sedation - Overnight stay
1 night - Recovery Time
1-2 Weeks
What is Incisional Hernia?
They are hernias that occur at the incision sites of previous abdominal surgeries. It may develop due to inadequacy of surgical technique, wound infection or factors that may impair the wound healing of the patient (obesity, diabetes, cortisone use, chronic lung disease). It is known that it develops after 10-15 of every 100 abdominal surgeries. They can occur after any type of incision.
For this reason, they are seen wherever the incision is made, they are not limited to a certain anatomical region such as the muscle or the navel. The incisions of the most common surgeries are most frequently encountered by the surgeon as incisional hernia. This may be a midline incision due to a stomach or intestinal surgery or a horizontal incision in the lower abdomen due to a cesarean section.Recent studies show that laparoscopic repair is superior and recurrence rates are lower in surgical site hernias.
Incisional Hernia Causes
The cause of a ventral hernia can vary depending on its location, your medical history, health, and personal anatomy. Weakness in the abdominal wall where the intestine protrudes may be part of your body's natural formation. It can also be caused by:
Chronic cough, severe or chronic vomiting
Diabetes or other diseases
Weight lifting
Injury or obesity
Pregnancy
Previous surgery
Diagnosing Incisional Hernia
To identify a ventral hernia, a healthcare professional may use more than one diagnostic technique, but will start with a medical history and physical examination. The doctor will ask and check certain questions as follows;
If there is constipation, “narrow” or “thin” stools
If there is lump or bulge in the abdomen; you may be asked to stand up and cough, which increases abdominal pressure and makes the hernia more prominent and easier to diagnose
If there are nausea, vomiting, fever, or rapid heartbeat or not.
If there is pain in the abdomen, especially around the bulge.
If the protruding part of the intestine becomes trapped within the abdominal wall, blood flow to the intestine may be cut off. This can cause other complications such as necrosis (tissue death). If your doctor suspects this is the case, additional diagnoses may include:
Blood tests to look for infections caused by intestinal obstruction or necrosis
Ultrasound, MRI, CT, or other imaging to check the obstruction or true location of the bowel protrusion
How is it treated?
The only effective treatment method is surgical repair. Over the years, many different surgical techniques have been applied, and now standard accepted methods have been determined. Today, incisional hernia surgery is performed with two methods.
Open Hernia Repair
In this surgical procedure, also known as herniorrhea, the surgeon makes an incision in the abdomen above the hernia, pushes the protruding intestines back into the abdomen and repairs the opening in the muscle wall. Sometimes in a procedure known as hernioplasty, the weak area is repaired and strengthened with steel mesh or wire.
Laparoscopic Method
In this minimally invasive surgical procedure, the surgeon makes several small incisions in the lower abdomen and inserts a camera-equipped tube-like instrument called a laparoscope into one of the incisions. Images are displayed on a large monitor that the surgeon uses to guide the operation. Using instruments placed in other incisions, the surgeon repairs the hernia with synthetic mesh and sutures or skin glue.