A surgical wound that is incompletely healed causes incisional hernias. Incisional hernias can occur soon after surgery or many years later. The patient often has a bulge at or around the site of incision and this is prominent when the muscles around the bulge are strained like when the patient coughs, stands up or lifts anything. The intestine can come out through the defect and stuck within the bulge and can lead to the intestinal obstruction which leads to abdominal distension, vomiting, and obstipation (not passing flatus and stool). If the blood supply to the intestine is compromised, it is called as 'strangulated hernia', which is a life-threatening condition.
Surgery is the only option to treat incisional hernias successfully. Surgery can be done by open or laparoscopic (Keyhole) approach. The tissue that is protruding is pushed back in place and is covered with a mesh (net made with special material) to ensure the hernia doesn’t reoccur.
It is the most popular repair nowadays. This is always under general anesthesia. The hernial repair will be done through 3 small holes (one 10 mm and two 5 mm). Sometimes, in complicated hernias, additional holes may be required. The abdomen is inflated with carbon dioxide gas. Protruding organs are put back in position. Defect covered with a special prosthetic mesh adequately on all sides and fixed with sutures and/or tackers. Recovery is quicker with this approach hence the hospital stay is reduced and the patient can regain their work earlier compared to open repair. There will only be small scars.
Through the previous incision, the hernia is explored and reduced. A piece of adequate size prosthetic mesh is kept over the defect to reinforce it. Mesh repair is associated with fewer recurrences. This is can be done under general/spinal anesthesia. In females who have a pendulous abdomen, hernia repair procedure can be combined with abdominoplasty (contour correction). Abdominoplasty requires a large, suprapubic transverse incision.
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