Incisional hernia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Soumya Sachdeva

An incisional hernia occurs when the area of weakness through which the hernia occurs, is the result of an incompletely healed surgical wound. Since median incisions in the linea alba are frequent for laparotomy, ventral incisional hernias are termed ventral hernia. These can be the most frustrating and difficult hernias to treat.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Soumya Sachdeva

These hernias present as a bulge or protrusion at or near the area of the prior incision scar. Virtually any prior abdominal operation can subsequently develop an Incisional Hernia at the scar area, including those from large abdominal procedures (intestinal surgery, vascular surgery), to small incisions (Appendectomy, or Laparoscopy). These hernias can occur at any incision, but tend to occur more commonly along a straight line from the breastbone straight down to the pubis, and are more complex in these regions.

1. Infection – Cases operated for peritonitis such as perforated duodenal ulcer, gangrene of the intestines.
2. Anatomical site – The midline of lower abdomen is highly prone, due to absence of posterior rectus sheath below the arcuate line.
3. Obesity with weak muscular tone.
4. Faulty sutures
5. Faulty technique of closure of the abdomen.
6. Ascites
7. Wrongly placed incisions tampering the nerves.
8. Persistent postoperative cough.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-In-Chief: Jinhui Wu, M.D.; Soumya Sachdeva

• Obesity
• Pregnancy
• A history of multiple abdominal surgeries
• Chronic and severe constipation
• Severe vomiting
• Chronic and intense coughing

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-In-Chief: Jinhui Wu, M.D., Soumya Sachdeva

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• Reducible hernia: There is a bulge in the abdominal area. It may be tender and can cause discomfort during any type of physical strain, such as lifting or coughing. The bulge may disappear when the patient is lying down, and be more visible when standing up.
• When a hernia cannot be pushed back into place, symptoms include pain, nausea, vomiting, inability to have a bowel movement, and a bulge that remains even when lying down.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Soumya Sachdeva

Hernias in this area have a high rate of recurrence if repaired via a simple suture technique under tension and it is especially advised that these be repaired via a TENSION FREE repair method using mesh (a type of synthetic net).

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