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Incisional Hernia

Posted On : January 08, 2016

After any type of abdominal surgery there is an inherent weakness or defect in the abdominal wall due to the incision that can lead to Incisional Hernia. Some weaknesses or defects can be present from birth or develop over a period of time. If the Incisional Hernia defect is large enough, abdominal contents such as the bowels, may protrude through the defect causing a lump or bulge felt by the patient. Hernias develop at certain sites which have a natural tendency to be weak; the groin, umbilicus (belly button), and previous surgical incisions.

Think of your hernia as a bulge in a tire. The outer wall of the tire is like your abdominal wall. The inner tube of the tire is like your intestines (Figure 1).

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Most of the time the outer wall of the tire is strong enough to hold the inner tube, but if the wall weakens, a bulge may occur (Figure 2).

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Just like a hernia may form in a weakness in the abdominal wall (Figure 3).

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What does a hernia feel like?

A hernia can be both seen and felt. You may notice it as a lump in your abdomen or groin that may or may not disappear when you lie down. You also may be aware of a dull aching sensation that becomes more pronounced when you are active.

Will my hernia go away?

An untreated hernia will not get better on its own, although it may not get worse for months or even years. A hernia that can be easily pushed back or flattened (reducible hernia) is generally not an immediate danger to your health, although it can be painful. A non-reducible hernia, however, can become life-threatening if part of the intestine gets trapped, or strangulated, in the opening. This is also called an incarcerated hernia and is an emergency situation that may require immediate surgery.

Why should hernia be repaired?

Hernias should be repaired for several reasons. Once a hernia has developed, it will tend to enlarge and cause discomfort. If a loop of bowel gets caught in the hernia, it may become obstructed or the bowels’ blood supply may be cut off. This could then become a life-threatening situation. Most hernias can be repaired effectively.

Why does a incisional hernia hurt?

The discomfort you feel, especially when you cough, lift something heavy, or stand for a long time, comes from the constant pressure of tissue pushing its way through the weakened spot in your body. As more tissue pushes through the weakened area, the feeling of pressure increases. A hernia that develops or worsens quickly can produce a sudden intense pain as it enlarges.

What can I do to feel better?

Limiting activity or eliminating excess weight may provide temporary relief. Wearing a truss or binder has also offered temporary relief. The only cure for an incisional hernia, however, is surgery. There are two reasons for hernia surgery: to correct or prevent a dangerous strangulated hernia, and to eliminate the pain that may be interfering with your normal activity. Although there are always risks and side effects associated with surgery, today’s surgical techniques provide patients with treatment options that offer minimal post-operative discomfort, speedy recovery, and lasting relief.

The repair of a hernia depends on the size of the hernia. The standard method of hernia repair involves making an incision in the abdominal wall. Normal healthy tissues are cut until the area of weakness is found. This area, the hernia, is then repaired with sutures. Often a prosthetic material such as  mesh, another plastic or biological material is sutured in place to strengthen the area and close the defect. Finally, the skin and other healthy tissues that were cut during the initial incision are sutured back together to complete the repair. Video of Laparoscopic Incisional Hernia Repair here.

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