Incisional hernias occur when organs push through weak spots in the abdominal wall at the site of previous surgery. Symptoms include swelling and tenderness, and a second surgery is needed to correct the hernia. Treatment options include open surgical repair or laparoscopic surgery, but complications can arise. Patients should avoid strenuous activity and take pain management medication while the incisional hernia site heals.
An incisional hernia develops at the site of previous surgery when organs push through weak spots in the abdominal wall. Most commonly, these are intestinal loops. The patient may notice swelling and tenderness around the incision site, and a second surgery is needed to correct the hernia and strengthen the abdominal wall to keep it in place. If left untreated, the patient can develop complications such as necrosis in the bulging tissue, which can lead to an infection in the intestines.
Abdominal incisions can be prone to incisional hernias because they weaken the hard tissues in the abdominal wall. These tissues normally keep the organs contained, but if they’re weakened by surgery, a vulnerable spot can be created. The hernia can occur shortly after surgery or it can happen years in the future and sometimes comes on very suddenly. Patients are more prone to this complication if they are overweight, have a history of breathing problems, or strain after surgery.
Those with signs of an incisional hernia may be examined to confirm the diagnosis. One option for treatment is an open surgical repair, in which the doctor will open up the site and install mesh to support the abdominal wall after pushing the bulging organ back into place. This can be a bad treatment option because the second surgical incision further weakens the intestinal wall, 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 hold it in place. In rare cases, it may be necessary to switch to open surgery due to complications that can arise while the patient is on the operating table.
Complications of incisional hernia repair can include a repeat hernia and an infection. Patients should be very careful about bending or lifting in the days following surgery and should not engage in strenuous physical activity until they get clearance from their doctors. Coughing and straining on the toilet can also cause the hernia to recur. The use of a stool softener may be recommended in addition to the pain management medications used to keep patients comfortable while the incisional hernia site heals.
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