Symptoms of an Incisional Hernia

• Bulge near surgical site: Often visible when standing, coughing, or lifting — may disappear when lying down.
• Pain or discomfort: Especially during physical activity, bending, or straining.
• Nausea or vomiting: May occur if the intestine becomes incarcerated.
• Mobility issues: Larger hernias may make it difficult to sit up or move comfortably.
• Strangulation: In severe cases, blood supply to the trapped tissue can be cut off — requires emergency medical attention.

How is Incisional Hernia Diagnosed?

A physical exam is usually sufficient to diagnose an incisional hernia, as the bulge is often visible when the patient stands or strains abdominal muscles. However, imaging tests such as ultrasound, CT scan, or MRI may be used to assess the size, contents, and plan the best surgical approach for repair.

Surgical Approaches to Incisional Hernia Repair

1. Open Hernia Repair

In open surgery, a single incision is made over the site of the hernia. The surgeon pushes the herniated tissue back into the abdomen and repairs the defect in the abdominal wall. A mesh is often used to reinforce the area and reduce recurrence rates.

• Advantages: Suitable for large or complex hernias.
• Advantages: Provides excellent visibility and access for the surgeon.
• Advantages: Ideal for patients not suitable for minimally invasive procedures.

2. Laparoscopic Hernia Repair

Laparoscopic surgery uses small incisions and a camera (laparoscope) to guide the repair. Special instruments are inserted through these incisions to fix the hernia, often using mesh to strengthen the abdominal wall.

• Advantages: Shorter recovery time.
• Advantages: Smaller incisions and less scarring.
• Advantages: Lower infection risk and less pain.
• Advantages: Quicker return to normal activities.
• Note: Can be technically challenging and requires specialized skills.

3. Robotic-Assisted Hernia Repair

Similar to laparoscopy but with enhanced precision using robotic arms controlled by the surgeon. Offers better flexibility and control, making it ideal for complex hernia repairs.

• Advantages: Enhanced precision and flexibility.
• Advantages: Similar benefits to laparoscopic surgery (small incisions, faster recovery).
• Advantages: Best suited for larger or recurrent hernias.

4. Mesh Use in Hernia Repair

Surgical mesh is commonly used in both open and laparoscopic repairs to provide extra reinforcement to the abdominal wall. It helps distribute tension and significantly reduces recurrence rates.

• Benefits of mesh: Decreases recurrence rates significantly.
• Risks: Rare complications include infection, migration, or rejection of mesh.

Recovery from Incisional Hernia Surgery

Recovery time depends on the surgical approach and hernia size.

• Minimally Invasive Surgery: Most patients resume light activities within 1–2 weeks and full recovery in 4–6 weeks.

Complications of Untreated Incisional Hernia

If left untreated, incisional hernias can grow larger and lead to serious complications.

• Incarceration: Hernia becomes trapped, causing bowel obstruction.
• Strangulation: Loss of blood supply to herniated tissue, which can cause tissue death and require emergency surgery.

Conclusion: Incisional hernias are a common complication of abdominal surgery but can be successfully treated with various surgical approaches. Early detection and intervention are key to preventing complications and ensuring smooth recovery. If you suspect you have an incisional hernia or are experiencing symptoms, consult your healthcare provider to discuss the most appropriate treatment options.