Diseased or injured organs inside the abdomen sometimes require surgery for repair or removal. Although more and more intra-abdominal conditions can now be addressed using laparoscopic techniques, using a camera and instruments introduced through small tubes, many still require a traditional incision. At the completion of the operation, this incision is then closed with suture material, to hold the tissues closely together, until they can grow together and heal. If a separation develops between these cut tissues, they will not grow together, and an abdominal wall defect occurs. A bulge will frequently be visible at the site of this INCISIONAL HERNIA.
The defect cannot heal itself, and may stretch and increase in size over time. Although uncommon, abdominal contents can even become entrapped (incarcerated) in the hernia bulge, and potentially have their blood supply choked off (strangulation). Fortunately, this latter event is very rare. Although some incision locations may be more (or less!) prone to develop herniation, any abdominal incision has the potential to result in an incisional hernia. There are multiple factors that can predispose to developing an incisional hernia, and all abdominal surgeons, no matter how skillful, will occasionally (and fortunately, rarely) have a patients develop an incisional hernia.
These hernias are almost always repaired using some form of patch material to bridge and reinforce the defect. In many cases, these repairs can be performed using minimally invasive outpatient laparoscopic techniques—minimizing pain, and resulting in a more prompt return to activities. Occasionally the characteristics of the hernia dictate a more traditional incisional approach. These decisions are best made by an experienced hernia specialist who is able to tailor the repair plan for each individual’s unique presentation.