An incisional hernia is a hernia that forms at the scar site of abdominal surgery. Post-surgery, the abdominal wall fails to heal and leaves a gap in the wall. This gap allows for parts of the intestinal tract or other digestive organs to push through into subcutaneous layers of the abdomen. An incisional hernia can happen after any abdominal surgery, with an average occurrence of 10 per cent. In most cases, laparoscopic surgery is recommended to correct the herniated area.
An incisional hernia may occur after any abdominal surgery but tends to happen more often among people who have either had multiple abdominal surgeries or are overweight. Two other groups that tend to be at higher risk of suffering from incisional hernias are women who are pregnant and people who suffer from a chronic cough.
The most common symptom of an incisional hernia is a bulge associated with discomfort at the site of the surgery. Other symptoms that might occur are a burning sensation, the feeling of fullness, persistent pain at the site of the scar and a general feeling that something is not right. Symptoms are the same for both men and women.
In most cases, diagnosis is something your physician can take care of in clinic. Your doctor will review your surgical history, palpate the area in question to feel for a bulge and question about level of pain and growth of the bulge over time. In some cases, an ultrasound or computed tomography (CT) might be used to confirm the diagnosis.
Reducible Hernia--This type can almost be viewed as an incomplete hernia. It is noticeably present only when you are standing. If you lie down, the organs settle away from the site of the hernia, and the hernia goes away. Gentle pressure can also be applied to push the organ back through the organ wall. Incarcerated Hernia--At this stage, the hernia does not go away because the organ is stuck in the muscle wall surrounding the abdomen. In severe instances, the bowel can become obstructed, leading to intense pain, abdominal distension and vomiting. Emergency surgical attention is required. Strangulated Hernia--In some instances, the neck of the hernia can obstruct the blood supply to the organ, resulting in tissue death and gangrene. This is quickly fatal if not treated immediately.
The most common treatment for incisional hernia is to treat through laparoscopic surgery since this form of surgery causes the least strain on the patient and thus has a greater chance for success. In cases of severe herniation, this may not be an option. Successful repair is the most common outcome of surgery on an incisional hernia; however, recurrence does occur in 25 to 50 per cent of cases (variation attributed to location and size of hernia). This percentage increases with each successive failure to repair.