Incisional Hernia Repair
Most hernias are due to an excessive amount of strain on a naturally weakened area of an individual’s abdomen or another membrane, causing an organ or tissue to protrude. Incisional hernias, however, are caused by strain on an area weakened by an incompletely healed surgical incision or wound in an individual’s past that caused a slight hole or tube to develop from that allows organs to be pushed through.
These hernias can vary in both size and shape, and as such are subject to different levels of injury and danger. These hernias can occur at any time after surgery, including directly after surgery’s completion to several years later, depending on the efficacy of the healing process and the thinning or stretching of the scar tissue.
Common Causes Of Incisional Hernias
Incisional hernias, like most hernias, are caused by strain to the weakened area. This strain can be caused by:
- Heavy, Improper Lifting
- Coughing or Vomiting
- Uncomfortable Bowel Movements
- Intense Physical Activities
Incisional Hernia Symptoms
Symptoms can vary depending on the type of hernia. Reducible hernias can be pushed back into place. Though these hernias are likely to occur again, reducible hernias have fewer side effects and are unlikely to become unhealthy, painful or dangerous.
Hernias that cannot be pushed back into place may have become “strangulated.” Strangulated hernias occur when the piece of organ or tissues have become trapped in the lining of the opening. Once trapped, strangulated hernias can become infected, possibly causing gangrene – a very serious infection that necessitates emergency surgery.
Strangulated hernias can also be very painful, and vomiting, nausea and bowel obstructions are common occurrences. Infection and other injury are possible. Also, since incisional hernias are caused by unhealed scar tissue rather than a naturally occurring weakness in specific area the abdominal wall, these hernias can expand causing greater pain and discomfort.
Even if the strangulated hernia is not painful, as some are not, it is still very important to receive surgery as all the additional risks like infection and gangrene may still occur.
Diagnosing An Incisional Hernia
Incisional hernias, as with most hernias, often have visible bulges that are easy for a physician to diagnose. A doctor may ask the patient to gently cough as they examine the bulge, as coughing usually causes a temporary increase in the hernia’s size. A hernia specialist may be necessary if the individual believes they have a hernia but the bulge is not visible.
Also, the doctor may ask the patient to lie down so that they can inspect the bulge again. Reducible hernias often disappear when an individual lies down and only reappears when he or she stands up. Irreducible hernia bulges tend to remain, as these bulges are stuck in the abdomen wall.
X-rays, MRIs and CT Scans are all useful for ensuring that the injury is a hernia and not another type of medical condition, though these are usually unnecessary as a diagnosis of a hernia tends to be a fairly simple process.
If the doctor believes you have a reducible hernia, they will usually push it back in but may request that the patient receive surgery to ensure it stays in its place. Strangulated irreducible hernias can only be healed through additional surgery.
Incisional Hernia Surgery Or Repair
A few incisional hernias, usually recurring reducible hernias, may be solved by wearing a special type of hernia belt that holds the bulge in place and does not allow it to stick out of the abdominal wall.
Still, due to the likelihood and dangers of strangulation, most patients that have been diagnosed with an incisional hernia receive surgery.
The most common type of hernia surgery is known as laparoscopic surgery. The patient is first put under anesthesia. The surgery involves opening up a very small area near the hernia, and looking into the area with a camera. The surgeon then uses special instruments to create small incisions that make it easy to remove the organ from the area it is stuck.
The surgeon then physically pushes the organ or tissues through the wall and seals the wall up with a mesh screen like a patch to ensure that even if the area remains weak, the organ cannot push itself through again.
Strangulated hernias may require emergency surgery and hospitalization, but most hernia surgeries are elective and done before the hernia reaches this point.
Healing time is usually minimal, and individuals who have had laparoscopic surgery often leave the hospital the same day. Some medicines and painkillers are prescribed, and general maintenance of the stitches is necessary, but at home care is not very difficult and the likelihood of reinjuring the hernia is low.