Incisional Hernia Repair

Incisional hernia occurs in an area where there is failure of a surgical wound to completely heal. According to statistics, of all the types of hernia, incisional hernia occurs in up to 11% of patients who have undergone any surgical procedure in the abdominal region. Also, after incisional hernia repair was done, due to lack of adequate care, recurrence has occurred in up to 44% of reported cases.

There are various reasons for an incisional hernia to occur. These include:

• Carelessness on the part of patients, like strenuous exercise or inadequate care.
• Faulty suturing done, or faulty sutures used by doctor.
• Secondary infection at wound site.

Incisional hernia has a higher tendency of occurring in the area between the end of the sternum and the pubic bone. Also, besides incisional hernias which normally occur on the dorsum (that is, in the abdominal areas), ventral hernias (hernias in the back region) can also occur. Ventral hernias are particularly difficult to treat.

Procedures for Incisional Hernia Repair

Simple suture technique under tension: In incisional hernia surgery, the herniated part is repaired using simple sutures, which are stitched under pressure. This was the traditional way of repairing hernias. However, it was seen that there were various drawbacks of this procedure. Firstly, lot of patients often complained of pain after the surgery. Secondly, there was a high recurrence rate seen. Also, the chances of incisional infections increased double fold after this kind of an incisional hernia repair procedure. Thus, the sutures used were then replaced by a mesh, which not only helped perform a tension free operation, but also ensured that the recurrence rate was considerably reduced.

Open Surgical Repair: This is a proper full-fledged operation which has to take place under general anesthesia. The site where the hernia has occurrred is opened, operated on and then stitched back. A tension free mesh is used, which is placed beneath the abdominal muscles in a secure fashion, to ensure that the herniated part is completely covered, thus, minimizing the chances of recurrence. This procedure is done when the hernia site is associated with a large incision, as is seen with major abdominal surgeries. It may also be done when the hernia is large, or there is a risk of a large open wound being associated with it. It is also mostly done with hernias that are difficult to treat such as ventral hernias and painful hernias associated with complicated surgeries. It is one of the most common incisional hernia repair procedure performed nowadays, as the recurrence rate is considerably reduced with this kind of corrective surgery.

Laparoscopic Incisional Hernia Repair: Laparoscopic surgery is a relatively new concept in treating incisional hernia symptoms. In this case, the incision site is not fully opened and explored. This operation is performed using instruments which are specially made for this procedure. In this surgery, a small incision is made on the side of the hernia, thus, ensuring that the original incision is not disturbed. This considerably reduces the risk of secondary infections. Then, a mesh is safely placed through this new incision, and the site is closed. This procedure not only reduces the risk of secondary infections and other such complications, but it is also a small and simple procedure to perform, thus, reducing the patient recovery time.

These were few procedures for incisional hernia repair. Although the recurrence rate is high, if adequate care and precautions are taken, a person can be rendered as fit as a fiddle in no time!