Incisional Hernia
What is the Incisional Hernia?
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Incisional hernia, also called post-incisional hernia, ventral hernia, or postoperative hernia. It develops from the scar from previous operations on the abdomen due to multiple causes:
Surgical wound infection from previous operations.
By rejection of the suture material.
Obesity at the time of the previous surgery or by gaining a lot of weight in the immediate or late postoperative period.
For exerting excessive efforts after being operated on.
Due to suffering from other concomitant diseases such as: Diabetes, pulmonary emphysema, prostate diseases, severe chronic constipation, malnutrition.
For one or more pregnancies after the first surgery.
For undergoing more than one surgery in the same place in the abdomen.
It is known that around 12% of abdominal operations develop incisional or ventral hernia and that some of these cases require more than one reoperation.
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Symptoms of Incisional or Postoperative Hernia
The most important symptom of incisional or post-incisional hernia
is the appearance of a mass at the site of the scar or very
close to it. This tumor increases its volume
as time passes and, occasionally or caused by
efforts, pain of different intensity is associated in the same place.
Diagnosis of Incisional or Post-incision Hernia
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The diagnosis of incisional or postoperative hernia is made
by examination by a hernia surgeon
that, on occasions, will need the diagnostic aid of some
imaging study such as ultrasound or tomography.
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Treatment of Incisional or Postoperative Hernias
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The treatment of incisional or ventral hernia is surgical and should be carried out as soon as it is identified since this type of hernia always grows with the passage of time and the possibility of its complication increases day by day.
The complications of incisional or postoperative hernia are:
a) Progressive increase in volume, reaching disproportionate dimensions, determining unsightly asymmetries of the abdomen that significantly alter the patient's self-esteem in addition to causing back pain.
b) Imprisonment. When any structure or organ of the abdomen protrudes or "comes out" through the hernia orifice and is definitively established without being able to return to its place through external maneuvers. This complication can cause intestinal obstruction and / or pain if it is the intestine that has "come out" through the orifice of the hernia.
c) Strangulation. When these mentioned structures are "hanged" by the hernia orifice causing them lack of circulation and the consequent death of the trapped organ, if it is the intestine, it can be perforated and produce peritonitis.
Treatment of incisional or postoperative hernia should always be surgical. Open techniques are the most used with or without the application of plastic meshes (prostheses), according to the criteria of the hernia surgeon. Open techniques for incisional hernia can be complemented with aesthetic plasty techniques of the abdominal wall to improve cosmetic results (abdominoplasty, abdominal liposculpture, etc.). Laparoscopic techniques (minimally invasive surgery or "laser surgery") can also be performed with the application of mesh in an internal position. Both techniques have very good results as they reduce postoperative pain, disability time, the use of analgesics and the possibility of a recurrence of the hernia in the future.
The risks of these surgeries are minimal as well as the possibility of postoperative complications, although it is often necessary to install surgical drains inside the abdominal wall that will remain in place for one to five days.
The recovery from incisional hernia surgery is one to three days of hospital stay and 15 to 20 days of relative rest, requiring constant abdominal bandaging for up to two to three months. You can return to work after 21 days, if it is low activity.
The hernia surgeon is responsible for deciding the best procedure for each patient.
