An incisional, or ventral, hernia can develop after abdominal surgery. It occurs when part of an internal organ or abdominal tissue protrudes through the abdominal wall.
In this article, we discuss what incisional hernias are and why they occur. We also look at treatment options and prevention tips.
An incisional hernia is the protrusion of abdominal tissue or parts of organs through the abdominal wall. They usually appear along, or close to, surgical scars on the abdomen.
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Most incisional hernias are not serious. However, they can get larger over time, which may affect normal breathing and movement. Large hernias can also be more challenging to operate on than smaller hernias.
People may require surgery to repair an incisional hernia. If an incisional hernia is small, not causing any problems, and has a low chance of causing complications, people may not need surgery.
In rare cases, the blood supply can become cut off to the protruding abdominal tissue. This is a medical emergency, and people will need immediate medical treatment.
If people have had previous abdominal surgery and notice any of the following symptoms, it could be a sign of an incisional hernia:
- a bulge near an old surgical incision
- sharp pain and discomfort when straining and lifting, which improves as a person rests
- aching, burning, or gurgling sensations
They most commonly appear along vertical incisions.
Abdominal surgery can sometimes cause incisional hernias.
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This means the abdominal wall is weaker around the area of scarring and is unable to stay intact against the pressure of the abdomen. Abdominal tissue, intestines, or organs may push through the weakened area and protrude.
According to Johns Hopkins Medicine, there is a 33% chance of developing an incisional hernia after abdominal surgery. Incisional hernias can occur any time after surgery, but are most likely to happen 3–6 months later.
Certain factors can increase the risk of developing an incisional hernia after surgery. A person is more likely to develop an incisional hernia if they:
- carried out strenuous or premature activity too soon after surgery
- became pregnant
- gained weight
This can increase the pressure on the abdomen before it had fully healed.
Other risk factors
- a large scar across the middle of the abdomen
- smoking
- older age
- having a condition that causes problems with wound healing, such as diabetes
Treatment for an incisional hernia can vary depending on each individual case. A doctor will consider a person’s overall health, the location and severity of the hernia, and the physical activity levels of the individual.
Treatment also depends on whether an incisional hernia has affected any previous abdominal surgery. A surgeon may need to repair the original surgery before treating the hernia.
If a hernia is small, not causing problems, and not likely to cause any complications, people might not need surgery. They may wear an abdominal binder around the abdomen to support the abdominal wall.
If people develop an incisional hernia within a
If someone requires surgical treatment, there are two types of surgery they may undergo:
Open surgery
A surgeon will cut open the abdomen to push the protruding tissue back into the abdomen.
They may also place a mesh over the weakened area to strengthen the abdominal wall, which reduces the risk of a hernia reoccurring.
Laparoscopic, or keyhole, surgery
A surgeon will make several small cuts into the abdomen and insert a tiny tube with a camera attached to the end of it. This allows them to see inside the abdomen and carry out surgery without cutting the abdomen open.
After repairing the hernia and damage to the abdominal wall, they may also attach a mesh to the abdominal wall to strengthen it.
Recovery
After surgery, people will have to take certain precautions to allow the abdominal wall to heal.
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If people have had open surgery, they may need to avoid strenuous lifting or activity for 3 months after surgery.
While people are recovering from an incisional hernia, they should:
- avoid heavy lifting, strenuous exercise, or any activity that strains the abdomen
- stop smoking if applicable, as this can slow down healing
- manage excess weight, as this can help reduce pressure on the abdominal wall
- make sure to manage any existing medical conditions, such as diabetes
A doctor will take a medical history and carry out a physical examination to diagnose an incisional hernia.
Signs a doctor may look for that could indicate an incisional hernia include:
- history of previous surgery
- any lump, protrusion, or swelling around the site of previous abdominal surgery
- a more visible protrusion of the lump when a person stands and coughs
- abdominal pain, particularly around any lump or swelling
- nausea
- vomiting
- rapid heart rate
The following may help to prevent incisional hernias following abdominal surgery:
- Make sure to follow any instructions the surgeon provides.
- Avoid heavy lifting or any activity that strains the abdominal muscles in the
first few months following surgery. - Manage excess weight around the abdomen, as this can increase pressure on an abdominal scar or weakened area.
- Avoid smoking, as this can cause slower wound healing.
- Manage any existing medical conditions, such as diabetes, to support wound healing.
In some cases, a doctor may advise that a person wears an abdominal binder or corset after abdominal surgery. This helps to support the abdominal wall, but there is
If people have a higher risk of developing an incisional hernia after surgery, a surgeon may place a wire mesh over the abdominal wall. This can help to lower the risk of developing an incisional hernia, but may cause symptoms such as chronic pain.
Most hernias are “reducible.” This means a healthcare professional can push the bulge back into the abdomen. However, complications can occur and can include an incarcerated hernia and a strangulated hernia.
An incarcerated hernia happens if the muscles of the abdominal wall trap the protruding abdominal tissue, and there is a permanent protrusion. This can lead to a strangulated hernia, which occurs if the blood supply is cut off.
A strangulated hernia is a medical emergency. People will need immediate surgery to prevent lasting damage or tissue death to the abdominal tissue.
People will need to seek immediate medical attention if they experience any of the following:
- severe pain, swelling, or inflammation around the area of the hernia
- rapidly growing lump or bulge
- nausea or vomiting
- bloating, and inability to pass gas or stools
- fever
- rapid heart rate
- bloody stools
A healthcare professional can carry out blood tests and imaging tests to check for an incarcerated or strangulated hernia. These tests can also check for infections, tissue death, or blockages in the abdomen.
If people have any symptoms of an incisional hernia, they can contact a doctor for a diagnosis and treatment plan.
People should seek emergency medical help if they experience any symptoms of a strangulated hernia.
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People may need keyhole or open surgery to repair an incisional hernia. Keyhole surgery is less invasive, and may have a quicker recovery time than open surgery. Avoiding excessive physical activity after surgery can allow the abdominal wall to heal better.
Incisional hernias can reoccur after treatment. Roughly
An incisional hernia can develop after abdominal surgery, due to a weakened abdominal wall. Abdominal tissue or parts of the intestines can bulge through the abdominal wall, around the area of scarring.
People may need surgery to treat an incisional hernia. Proper rest and recovery after surgery may help to prevent an incisional hernia.