Incisional hernia

Definition

An incisional hernia is a protrusion, which occurs through a defect in the site of a previous abdominal incision/ scar.

Who commonly presents with it?

Any person that has undergone previous abdominal surgery can develop a weakness at the site of the previous scar.  Obesity is a common risk factor. It is also more common in patients that may suffer from chronic constipation, a chronic cough and/or possible difficulty in passing urine.

How does it present?

An incisional hernia usually presents by a 'bulging' at or close to the site of the abdominal scar. It is particularly apparent on standing, lifting heavy objects and can disappear on lying down. The hernia presents and progresses over time and can be painful as well as unsightly. Other more serious complications include bowel obstruction presenting with nausea, vomiting and gross swelling of the abdomen. In some cases the bowel's blood supply can be cut off resulting in a condition called an 'incarcerated hernia' and this is a recognised surgical emergency.

What can be done?

Upon diagnosis, simple treatment measures involve the use of a specially designed corset or belt to support the hernia. Surgery is recommended to reduce the size of the hernia and help control symptoms of pain. The operation involves reducing the contents of the hernia into the abdomen and repairing the defect in the abdominal wall by using a suitably sized mesh, which reinforces the repair. The operation can be performed by the conventional open technique utilising the previous incision or by a keyhole technique. The surgeon determines the type of repair possible.

How long will your recovery take?

Recovery is based on the type of operation that you have. Open surgery recovery is dependant upon the size of the hernia and generally patients are encouraged to start mobilising gently immediately after surgery and refrain from lifting heavy objects for at least two to three weeks. A return to full activities is expected within 6 weeks. Keyhole surgery has a quicker recovery time.

What are the main risks of surgery?

Your surgeon will advise on any specific complications and risks. For all types of surgery there is always a risk of wound infection and a 1-2% risk of recurrence of the hernia.