What Is an Incisional Hernia?

An incisional hernia develops at the site of a previous surgery when organs push through weak spots in the abdominal wall. Most commonly, this involves loops of bowel. The patient may notice swelling and tenderness around the incision site and a second surgery is required to correct the hernia and reinforce the wall of the abdomen to keep it in place. If left untreated, the patient can develop complications like necrosis in the protruding tissue, which can cause an infection in the bowel.

Abdominal incisions can be prone to incisional hernias because they weaken the tough tissues in the abdominal wall. These tissues normally keep the organs contained, but if they are weakened by a surgery, a vulnerable point may be created. Herniation can occur shortly after surgery or it may happen years in the future, and sometimes it onsets very suddenly. Patients are more prone to this complication if they are overweight, have a history of breathing problems, or strain themselves after surgery.

Those with signs of an incisional hernia can be examined to confirm the diagnosis. One option for treatment is an open surgical repair, where the doctor will open up the site and install a mesh to support the abdominal wall after pushing the protruding organ back into place. This can be a poor treatment option because the second surgical incision weakens the bowel wall even further, increasing the chance of another incisional hernia in the future.

Alternatively, a surgeon may recommend a laparoscopic approach. In this procedure, very small incisions are made to insert tools and a camera to work on the hernia without disturbing the old surgical site. The surgeon can reposition the organ and implant a hernia mesh to keep it in place. In rare cases, it may be necessary to convert to an open surgery because of complications that may arise while the patient is on the operating table.

Complications of incisional hernia repair can include a repeat hernia as well as infection. Patients need to be very careful about bending or lifting in the days after surgery, and shouldn’t engage in heavy physical activity until they get a clearance from their doctors. Coughing and straining on the toilet can also cause the hernia to recur. Use of a stool softener may be recommended in addition to pain management medications used to keep patients comfortable while the site of the incisional hernia heals.