An incisional hernia is a common complication associated with abdominal surgery.
Some hernias are painful while others are asymptomatic.Strangulated hernias might be extremely painful, and require immediate medical attention.
They are rare, occurring in fewer than 5% of all hernias.
Illustration by Ellen Lindner for Verywell Health
If you have a hernia, there may be ways to manage it medically.
However, the only absolute cure is surgery to repair the abdominal wall.
Illustration by Ellen Lindner for Verywell Health
What Are the Symptoms of an Incisional Hernia?
Illustration by Brianna Gilmartin, Verywell
An incisional hernia can cause a bulge on the abdomen where the hernia is located.
It can become more pronounced when the patient coughs.
People with an incisional hernia might also have gastrointestinal symptoms like constipation, bloating, nausea, and vomiting.
This is a medical emergency.
Symptoms are extreme pain, discoloration and burning of the hernia, fever, nausea, and vomiting.
What Are the Causes of an Incisional Hernia?
The incision is the weakest and most prone to a hernia while still healing.
In severe cases, portions of organs may move through the hole, but this is much less common.
A hernia that gets stuck in the “out” position is called anincarcerated hernia.
A strangulated hernia can cause necrosis (death) of the bulging tissue through the hernia.
A strangulated hernia may have a deep red or purple color of the bulging tissue.
It may be accompanied by severepain, but it is not always painful.
Nausea, vomiting, diarrhea, and abdominal swelling may also be present.
How Are Incisional Hernias Diagnosed?
Incisional hernias may seem to appear and disappear.
This is described as areduciblehernia.
Your doctor can diagnose your hernia with a physical examination, which doesn’t usually require diagnostic testing.
How Are Incisional Hernias Treated?
An incisional hernia may needsurgical repairto prevent it from getting larger and to prevent incarceration or strangulation.
A truss is a nonsurgical option.
A truss treats the symptoms of a hernia and not the actual hernia.
The only curative treatment is surgical repair.
In some cases, deciding whether to have surgery is up to you.
Incisional Hernia Repair Surgery
Incisional hernia repair surgery is typically done on aninpatientbasis and requiresgeneral anesthesia.
The surgery is often performed using the laparoscopic method, using small incisions rather than a large open incision.
A general surgeon or a colorectal specialist performs surgery.
Laparoscopic Repair
During the procedure, incisions are made on either side of the hernia.
Alaparoscopeis inserted into one incision, and the other incision is used for the insertion of additional surgical instruments.
If the defect in the muscle is minor, it may besuturedclosed to prevent the hernia from returning.
For large defects, suturing might not be adequate.
In this case, the hernia is closed, and a mesh graft will cover the hole.
The mesh is permanent and prevents the hernia from returning.
The laparoscope is removed once the mesh is in place or the muscle has been sewn.
The skin incision is closed.
The incision is typically closed with dissolvable sutures.
Medical glue or adhesive strips (Steri-Strips) may also be used.
Open Hernia Repair
Surgeons might do an open hernia repair instead of a laparoscopic repair.
Recovery typically takes a little longer in open surgery than in laparoscopic surgery.
Whats the Recovery Process Like?
Most people with hernia repair surgery can return to normal activity within about three weeks after surgery.
The abdomen will be tender, especially for the first week after surgery.
Potential Complications
Every surgical procedure has potential complications.
Summary
Surgical scars can cause tissue to bulge through the abdominal wall, causing an incisional hernia.
If a hernia is not treated, it can become strangulated, which has very serious consequences.
The treatment for this is a surgical repair, either laparoscopic or open.
The procedure is usually well-tolerated, and recovery takes about three weeks for most people.
National Institutes of Health.Hernias: Incisional Hernia Repair.
Institute for Quality and Efficiency in Health Care (IQWiG); 2020.
13(3):e14038.
doi:10.7759/cureus.14038
U.S. Food and Drug Administration.Hernia Surgical Mesh Implants.
Ahn BK.Risk factors for incisional hernia and parastomal hernia after colorectal surgery.J Korean Soc Coloproctol.
2012;28(6):280-281. doi:10.3393/jksc.2012.28.6.280
Columbia Hernia Center.Hernia Types, Causes, and Treatments.
Berger D.Evidence-Based Hernia Treatment in Adults.Dtsch Arztebl Int.
2021;5(1):zraa010.
doi:10.1093/bjsopen/zraa010
University of Michigan Health.Open Inguinal Hernia Repair (Herniorrhaphy, Hernioplasty).
2019;8:Doc09.
