Incisional Hernias

What is an incisional hernia?

An incisional hernia can potentially occur after any abdominal surgery. An abdominal incision leads to potential weakness of the abdominal wall with the possibility that an incisional hernia may develop, sometimes years later after the initial surgery. The risk is much smaller with minimally invasive surgery (port site hernia) but still exists.

What are the symptoms of an incisional hernia?

The most noticeable symptoms of incisional hernia is a bulge near the incision area. The most feared complications of incisional hernias (and most other hernias) are incarceration (inability to reduce the hernia) and strangulation (the blood supply to the hernia contents is cut off possibly leading to necrosis and perforation of the contents). Most hernias will need to be repaired in order to avoid these potential complications. Other than the visible bulge, incarcerated incisional hernias may also cause symptoms such as:

• Nausea and vomiting
• Fever
• Abdominal pain and discomfort around the hernia
• Tachycardia (Faster heartbeat than normal)
• Constipation / Obsipation (Not passing stool or flatus)
• Diarrhoea

The following factors will increase the risk of an incisional hernia developing:

• Wound infection
• Obesity
• Smoking
• Diabetes

What are the possible treatment options for incisional hernias?

Once an incisional hernia has developed, it will need to be repaired to avoid the complications of incarceration and strangulation. The repair will generally involve the placement of a synthetic mesh to decrease the risk of hernia recurrence. This can be done in an open or minimally invasive manner. A minimally invasive approach lessens the risk of hernia recurrence and mesh infection, but is not suitable for very large / complex hernias.

• Open repair
  During an open hernia repair, Dr Cooper will make an incision at the hernia’s site. He will then return hernial contents into the abdominal cavity and perform a tension free repair of the hernia by mobilising the different layers of the abdominal wall to achieve closure. A mesh will be used to reinforce hernia repair and lessen the risk of a recurrence.
• Laparoscopic repair
  Laparoscopic incisional hernia repair is a minimally invasive procedure. During a laparoscopic hernia repair, Dr Cooper will make 3 small incisions on the side of your abdomen, through which 3 ports are introduced and CO2 is inflated to create space to work. The surgeon will clear adhesions from the edges of the hernia opening and then fix a mesh (introduced via one of the ports) over the hernial defect. Patients can generally be discharged 24-48hrs post-surgery.