A ventral hernia is a tissue defect that develops at a location where a surgical incision has been previously made. In a ventral hernia repair procedure, this surgical hernia is repaired, and the weakened tissue is strengthened with surgical techniques. Ventral hernia repair is also known as incision hernia repair, because the hernia develops at the site of a previous surgical incision.
Ventral hernia typically develops in the wall of the abdomen but also can occur in the groin or any location where a surgical incision is present. At the site of a previous surgical incision, muscles tend to be weaker than normal, and this weakness can lead to a tear or bulge in the muscle. When this occurs, part of an organ, such as the intestine or bowel, can protrude through the tear in the muscle. This protrusion is called a hernia.
The most common symptom of a ventral hernia is the characteristic bulge in the abdomen, caused by the protrusion of tissue through the tear in the muscle wall. Not all ventral hernias cause pain, but even if no pain is present, the site might be tender and uncomfortable when pressure is exerted. Physical strain such as coughing, lifting and bowel movements can be sources of pressure and can cause pain at the hernia site. Even if no pain is present, ventral hernia repair still is a necessary procedure to prevent the hernia from worsening.
Ventral hernia repair can be carried out using open surgery or laparoscopic surgery. In open surgery, a large incision is made in the abdomen, through which the surgeon repairs the hernia by pushing the dislocated tissue back into place. Next, he or she strengthens the muscle wall by trimming excess tissue and stitching the muscle tear closed. The surgeon might also use synthetic mesh supports to strengthen the muscles.
Laparoscopic surgery includes similar steps to repair the hernia but is carried out very differently. In this type of surgery, several very small incisions are made in the abdomen, instead of one large incision. Laparoscopic instruments, a light source and a tiny video camera are inserted through these incisions. The camera transmits images to an overhead screen that provides the surgeon with a view of the interior of the abdomen.
Recovery time after ventral hernia repair is much faster when the surgery is carried out laparoscopically. In most cases, a patient can leave the hospital within 24 hours after undergoing laparoscopic surgery, whereas a stay of several days might be needed after open surgery. Additional advantages of laparoscopic surgery are that most patients recover more quickly, have less pain and can return to normal levels of activity much sooner. When the procedure is performed by an experienced surgeon, a relapse of the hernia is much less likely to occur after laparoscopic surgery.