Incisional Hernia Surgery

Celebrities who have suffered from Hernia

Amitabh Bachchan

Dwayne Johnson

Denise Richards

Amazing Facts About Incisional Hernia

• Occurrence: Incisional Hernia protrudes through a weakened or previous surgical incision in the abdominal wall. It is a specific type of hernia that can develop after abdominal surgery. (Source)

• Delayed Onset: Incisional hernias may develop weeks, months, or even years after the initial surgical incision. This delayed onset is due to the gradual weakening of the abdominal wall over time. (Source)

• Recurrence: Incisional hernias have a higher risk of recurrence compared to other types of hernias. The risk increases with larger hernias, inadequate surgical technique, underlying medical conditions, and lifestyle factors such as smoking and obesity. To reduce the risk of recurrence, proper surgical technique, adequate mesh placement, and addressing modifiable risk factors are crucial. (Source)

4 Reasons for Early Treatment of Incisional Hernia

1. Prevention of complications: Early treatment can help prevent complications such as incarceration and strangulation of the hernia, which can lead to tissue damage and necrosis.
2. Pain relief: Early treatment can alleviate discomfort and pain associated with the hernia, improving the individual’s quality of life.
3. Restoration of normal function: Treatment can restore normal abdominal function, allowing individuals to resume their daily activities without restrictions caused by the hernia.
4. Cosmetic improvement: Early treatment can address the visible bulge or deformity caused by the hernia, improving the individual’s body image and self-confidence.

Complications of Untreated Incisional Hernia

1. Hernia Incarceration: If an incisional hernia is left untreated, there is a risk of the hernia becoming incarcerated. This means that the hernia contents become trapped and cannot be pushed back into the abdominal cavity. It can lead to severe pain and discomfort.
2. Strangulation: In some cases, an untreated incisional hernia can progress to strangulation. This occurs when the blood supply to the hernia contents is compromised, leading to tissue damage and potential infection. Strangulated hernias require immediate surgical intervention.
3. Bowel Obstruction: An untreated incisional hernia can lead to bowel obstruction. The hernia can compress or block the intestines, causing symptoms such as abdominal pain, nausea, vomiting, and an inability to pass stool or gas.
4. Hernia Enlargement: If an incisional hernia is left untreated, it can progressively increase in size over time. This can result in more significant symptoms and complications, making it more challenging to repair surgically.

What is Incisional Hernia?

Risk Factors to develop Incisional Hernia

1. Previous abdominal surgery: Having undergone previous abdominal surgery, especially if it involved a large incision or improper wound closure, can weaken the abdominal wall and increase the risk of developing an incisional hernia.
2. Obesity: Excess weight and obesity can put increased pressure on the abdominal wall, making it more prone to hernias. The additional strain can weaken the incision site and increase the risk of an incisional hernia.
3. Poor wound healing: If the incision from a previous surgery does not heal properly or becomes infected, it can weaken the abdominal wall and increase the likelihood of developing an incisional hernia.
4. Chronic cough or constipation: Conditions that cause chronic coughing, such as chronic obstructive pulmonary disease (COPD) or persistent constipation, can strain the abdominal muscles and increase the risk of developing an incisional hernia.
5. Smoking: Smoking has been associated with impaired wound healing and increased risk of complications after surgery, including the development of incisional hernias.
6. Diabetes: Diabetes can affect the body’s ability to heal wounds properly, making individuals with diabetes more susceptible to developing incisional hernias.
7. Age: The risk of developing an incisional hernia increases with age. As individuals get older, the abdominal tissues may become weaker and less able to withstand the stress of an incision.

Symptoms of Incisional Hernia

• A noticeable bulge at the site of the surgical incision, 
• Pain or discomfort, especially when lifting or straining, and 
• A feeling of pressure or fullness

Diagnosis of Incisional Hernia

1. Medical History: The doctor will begin by asking about the patient’s medical history, including any previous surgeries, especially in the abdominal area. They will inquire about any symptoms experienced and the timing of the appearance of a bulge or swelling.
2. Physical Examination: The doctor will perform a physical examination to assess the area where the incision was made. They will visually inspect the area and may gently press on the abdomen to feel for any bulging or protrusion. The examination helps determine the size, location, and characteristics of the hernia.
3. Medical Imaging: In some cases, particularly when the hernia is not readily visible or there is uncertainty about the diagnosis, medical imaging tests may be recommended. These may include: a. Ultrasound: This imaging technique uses high-frequency sound waves to produce images of the abdominal wall. It can help confirm the presence of a hernia, determine its size and location, and assess any complications or abnormalities. b. CT Scan: A computed tomography (CT) scan provides detailed cross-sectional images of the abdomen. It can help visualize the hernia, evaluate its size and location, and identify any associated complications or underlying causes.

Treatment of Incisional Hernia

Laparoscopic Incisional Hernia Surgery

Benefits of Laparoscopic Incisional Hernia Surgery

1. Minimally invasive: Laparoscopic surgery involves smaller incisions, resulting in less scarring and reduced postoperative pain.
2. Faster recovery: Patients who undergo laparoscopic surgery for incisional hernias generally experience a quicker recovery time compared to open surgery.
3. Reduced risk of complications: Laparoscopic procedures have a lower risk of infection, wound complications, and hernia recurrence compared to open surgery.
4. Shorter hospital stay: Most patients can be discharged from the hospital on the same day or within a few days after laparoscopic surgery.

Preparation for Incisional Hernia Surgery

1. Consultation with a Surgeon: Schedule a consultation with a surgeon who specializes in hernia repair. During this appointment, the surgeon will assess your hernia, review your medical history, and discuss the surgical options available to you.
2. Medical Evaluation: Your surgeon may request certain medical evaluations to assess your overall health and determine your eligibility for surgery. These may include blood tests, imaging studies (such as a CT scan), and an electrocardiogram (ECG) to evaluate your heart function.
3. Medication Review: Inform your surgeon about all the medications you are currently taking, including prescription drugs, over-the-counter medications, and supplements. Your surgeon will provide instructions on which medications to continue or discontinue before the surgery.
4. Fasting: You will be instructed to fast for a specific period of time before the surgery. This is typically about 8 hours for solid food and 2 hours for clear liquids. Fasting helps reduce the risk of complications during the procedure.
5. Anesthesia Consultation: If general anesthesia or sedation will be used during the surgery, you may need to schedule a separate consultation with an anesthesiologist. The anesthesiologist will evaluate your medical history, discuss the anesthesia options available, and address any concerns you may have.
6. Lifestyle Adjustments: Your surgeon may recommend certain lifestyle adjustments to optimize your health before the surgery. This may include quitting smoking, maintaining a healthy weight, and engaging in regular physical activity. These measures can help reduce the risk of complications and promote a faster recovery.
7. Preoperative Instructions: Follow any preoperative instructions provided by your surgeon. These may include guidelines on when to stop eating and drinking before the surgery, instructions on showering with antibacterial soap, and details about any required bowel preparation.
8. Support and Assistance: Arrange for a family member or friend to accompany you to the surgery and help with transportation and postoperative care. Having support during the recovery period can greatly aid in your comfort and well-being.

Anaesthesia for Incisional Hernia Surgery

1. General Anesthesia: In general anesthesia, the patient is completely unconscious and unaware during the surgery. It is administered by an anesthesiologist through intravenous medications and inhaled gases. General anesthesia allows for complete relaxation of the patient’s muscles, ensuring optimal surgical conditions. The patient is closely monitored throughout the procedure to maintain vital signs and ensure safety.
2. Local Anesthesia with Sedation: In some cases, hernia surgery may be performed under local anesthesia with the addition of sedation. Local anesthesia involves injecting a numbing medication into the surgical area to block pain sensation. Sedation is administered through intravenous medications to help the patient relax and remain comfortable during the procedure. With this type of anesthesia, the patient is usually awake but feels drowsy and relaxed.

Recovery after Incisional Hernia Surgery

1. Hospital Stay: The length of your hospital stay will depend on the extent of the surgery and your overall health. In some cases, incisional hernia surgery can be performed as an outpatient procedure, allowing you to go home on the same day. However, in more complex cases, an overnight hospital stay may be required.
2. Pain Management: It is normal to experience some pain and discomfort at the surgical site after the procedure. Your doctor will prescribe pain medications to help manage post-operative pain. Take the medications as instructed and report any severe or worsening pain to your healthcare provider.
3. Incision Care: Proper care of the surgical incision is important for preventing infection and promoting healing. Follow your surgeon’s instructions on how to keep the incision clean and dry. You may need to change the dressing regularly and apply any recommended ointments. Avoid soaking in baths or swimming until your healthcare provider gives you the go-ahead.
4. Physical Activity: During the initial recovery period, it is crucial to limit physical activity and avoid strenuous activities that may strain the surgical site. Your surgeon will provide guidance on when you can resume regular activities and exercise. Walking is often encouraged to promote blood circulation and prevent blood clots, but avoid heavy lifting or intense workouts until cleared by your healthcare provider.
5. Diet and Nutrition: Follow any dietary instructions provided by your surgeon or dietitian. It is common to start with a liquid or soft diet initially and gradually transition back to a regular diet as tolerated. Stay hydrated and consume fiber-rich foods to prevent constipation, which can be a common side effect of surgery and pain medications.
6. Follow-up Appointments: Attend all scheduled follow-up appointments with your surgeon. These visits allow your surgeon to monitor your healing progress, remove any stitches or staples if necessary, and address any concerns or complications that may arise.
7. Signs of Complications: Be vigilant for any signs or symptoms that may indicate complications, such as excessive bleeding, severe pain, redness, swelling, pus or discharge from the incision site, fever, or difficulty passing urine or stools. If you experience any of these symptoms, contact your healthcare provider immediately.

Risks and side effects of Incisional Hernia Surgery

1. Risk of complications: While laparoscopic surgery is generally safe, there is a small risk of complications such as infection, bleeding, or injury to surrounding organs or blood vessels.
2. Recurrence of the hernia: Although laparoscopic surgery has a low recurrence rate, there is still a possibility of the hernia recurring in some cases.
3. Anesthesia-related risks: As with any surgical procedure, there are risks associated with anesthesia, but these risks are generally low.