Incisional Hernia

An incisional hernia is a type of hernia that occurs when an internal organ or tissue protrudes through a weakness in the abdominal wall at the site of a previous surgical incision. This hernia typically develops after a person undergoes abdominal surgery, as the incision site may not fully heal or may become weakened over time.

Bulge or swelling at or near the site of the surgical scar, which may become more pronounced when standing, coughing, or straining.
Pain or discomfort around the hernia site, which may worsen with physical activity or lifting heavy objects.
In some cases, if the hernia becomes incarcerated (trapped tissue) or strangulated (blood flow cut off), more severe symptoms can occur, including:
- Severe pain at the hernia site
- Nausea and vomiting
- Inability to push the bulge back in

Infection at the surgical site: Infections can interfere with the healing process, increasing the risk of hernia formation.
Obesity: Excess weight places additional strain on the abdominal wall and increases the risk of developing an incisional hernia.
Chronic coughing or sneezing: Conditions like chronic obstructive pulmonary disease (COPD) or allergies can increase intra-abdominal pressure, contributing to hernia formation.
Heavy lifting or straining: Lifting heavy objects or frequent straining during bowel movements or urination can put pressure on the abdominal muscles, increasing the risk.
Poor wound healing: Factors like malnutrition, smoking, or certain medical conditions (e.g., diabetes) can impair the healing process of the surgical site, making it more vulnerable to hernia development.

Conservative management: In some cases where the hernia is small and not causing significant discomfort, monitoring might be sufficient, though surgical intervention is often recommended to avoid complications.
Surgical repair: The most common and effective treatment for incisional hernias is surgery. The options include:
- Open surgery: The surgeon makes an incision over the hernia site to push the protruding tissue back into place and repair the weakened area with sutures +/- mesh.
- Laparoscopic surgery: A minimally invasive technique in which small incisions are made, and the hernia is repaired using specialized instruments and a camera +/- mesh.