Introduction
An incisional hernia occurs when the muscles or tissues around a previous surgical incision site do not fully heal or may be due to some infection leaving a weakness in the abdominal wall. It occurs when the muscles or tissues in the area of the incision are weak or damaged, allowing a protrusion of abdominal contents through the weakened area and forming a bulge. Incisional hernias can be painful and cause discomfort or difficulty with physical activity. They can cause complications such as bowel obstruction if left untreated. In such a scenario, an incisional hernia repair is recommended. It is a surgical procedure used to treat a hernia that has developed at a previous abdominal incision site. This procedure aims to repair the weakened area of the abdominal wall and prevent the hernia from recurring.
Treatment of Incisional Hernia
Treatment for an incisional hernia typically involves surgery to repair the weakened abdominal wall area, called Incisional hernia repair. It is a surgical procedure to repair the weakness in the abdominal wall and return the protruding intestine or other abdominal contents to their normal position. The surgery is typically performed using general anesthesia. Depending on the individual case, it can be done through open or laparoscopic surgery. Open surgery involves a single large incision, while laparoscopic surgery uses several small incisions and specialised instruments. It is the size and location of the hernia and the patient’s overall health that determine the type of surgery. The surgical repair of an incisional hernia involves placing a strong, synthetic mesh over the weakened area of the abdominal wall. This mesh provides additional support and helps to hold the abdominal contents in place, reducing the risk of hernia recurrence. The mesh is usually secured to the surrounding tissue using sutures or special tacks.
During open surgery, the surgeon will make an incision in the abdominal wall to access the hernia and identify the hernia and repair the weakened area. The hernia sac is then carefully dissected away from the surrounding tissues, and the hernia defect is repaired. The surgeon may use sutures, mesh, or both to close the defect and strengthen the abdominal wall.
Laparoscopic surgery is less invasive as compared to open surgery. It involves making several small incisions in the abdomen using specialised instruments, including a laparoscope, a thin and flexible tube with a light, and a camera at the end used to have a view of the inside of the abdomen. During laparoscopic incisional hernia repair, the surgeon makes several small incisions in the abdominal wall and inserts the laparoscope and other instruments through the incisions. The hernia is repaired using similar techniques as in open surgery, but the smaller incisions and use of laparoscopy result in less pain and a faster recovery.
Regardless of the approach used, strengthening the abdominal wall and preventing the hernia from recurring are the main goals of incisional hernia repair. Recovery from incisional hernia repair surgery can take several weeks and may involve pain management, wound care, and physical therapy to help restore strength and mobility.
Risks and Complications
Incisional hernia repair surgery is generally considered safe and effective, but as with any surgery, there are potential risks and complications. The success rate for incisional hernia repair is high, with most patients experiencing a significant improvement in their symptoms. As with any surgical procedure, there is a risk of complications, including infection, bleeding, mesh rejection, allergic reactions to anesthesia, and damage to nearby organs or tissues. Discussing the potential risks and benefits of incisional hernia repair with a healthcare provider is essential to determine the best treatment plan.
Recovery
Recovery from incisional hernia repair typically takes several weeks. Patients may need to limit physical activity and avoid heavy lifting for some time to allow the incision to heal. Pain and discomfort can be managed with over-the-counter or prescription pain medication.
Lifestyle changes and the way forward
In addition to surgery, lifestyle changes can help prevent the development of incisional hernias or reduce the risk of recurrence. It is important to maintain a healthy weight, quit smoking, and manage any underlying medical conditions to reduce the risk of developing an incisional hernia or experiencing complications after surgery:
- Maintaining a healthy weight: Excess weight can strain the abdominal muscles, increasing the risk of a hernia.
- Avoiding heavy lifting: Lifting heavy objects can strain the abdominal muscles and increase the risk of a hernia.
- Quitting smoking: Smoking can weaken the muscles in the abdominal wall and increase the risk of a hernia.
Conclusion
Recovery from incisional hernia repair surgery can take several weeks and may involve pain management, wound care, and physical therapy. Overall, incisional hernia repair is a safe and effective treatment option for individuals who have developed a hernia at the site of a previous abdominal incision. Suppose you are experiencing symptoms of an incisional hernia. In that case, you must talk to your doctor to determine the best treatment for your needs.
FAQs
Is incisional hernia repair major surgery?
Yes, incisional hernia repair is considered a major surgery requiring general anesthesia and usually involves making a large incision or a few smaller incisions, depending on the type of surgery in the abdominal wall to access and repair the hernia.
What causes an incisional hernia?
An incisional hernia can occur due to various factors, including improper healing after surgery, excessive strain on the abdominal muscles, and obesity.
How to know if one has an incisional hernia?
Symptoms of an incisional hernia may include a bulge or lump at the site of previous surgery, pain or discomfort in the abdominal area, and difficulty with physical activities.
Can an incisional hernia be prevented?
The risk of developing an incisional hernia can be reduced by maintaining a healthy weight, avoiding activities that strain the abdominal muscles unnecessarily, and quitting smoking.
Is incisional hernia repair surgery risky?
As with any surgery, there are potential risks involved with incisional hernia repair. These may include infection, bleeding, and reactions to anesthesia. Your surgeon will discuss the risks and benefits of the procedure with you before the surgery.
What is the recovery time from incisional hernia repair surgery?
The recovery time after incisional hernia repair surgery will depend on the type of surgery performed and the individual patient. Generally, open surgery has a longer recovery time than laparoscopic surgery. Recovery from incisional hernia surgery typically takes several weeks, with most people able to return to normal activities after 4-6 weeks.
Will I have a scar after incisional hernia repair surgery?
Yes, you will have a scar after incisional hernia repair surgery. The size and location of the scar will depend on the type of surgery performed and the size of the hernia.
Can an incisional hernia return after surgery?
Most incisional hernias usually do not return after surgery. Still, about 5 percent of them come back in patients who have had a previous repair.
Is an incisional hernia serious?
Yes, an incisional hernia can be serious and potentially lead to complications if left untreated. It can cause pain, increase the risk of intestine obstruction, and lead to other problems if the hernia becomes incarcerated or strangulated.
What is the success rate of incisional hernia repair?
Incisional hernia repair success rate is generally high, with studies reporting success rates of 85-95%. However, the risk of hernia recurrence is higher for incisional hernias than other hernias. The success of the surgery depends on various factors, like the size and location of the hernia, the patient’s overall health, and the type of surgical repair performed.
References :
https://emedicine.medscape.com/article/1892407-overview
https://www.ncbi.nlm.nih.gov/books/NBK395550/
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