Incisional Hernia

When a surgical wound does not heal properly and a muscle, tissue or even a part of an organ protrudes through that wound, the condition is called incisional hernia. When such a protrusion results through a surgical wound, you will face an excruciating pain and even swell in that region. In worst cases, strangulation of organs can also result due to incisional hernia.

What are the causes of incisional hernia?
The several causes of incisional hernia are:

  • One of the obvious causes of incisional hernia is a surgical wound.
  • An incisional hernia occurs mainly because the muscle layers are not strong enough. So, when the patient is old, the incisional hernia is common.
  • When there is an increased intra-abdominal pressure just after an operation, the incisional hernia can occur. This pressure might result due to a chronic cough. So, if the patient suffers from any lung problem just after the operation which leads to a chronic cough or vomiting, the incisional hernia can occur. When too much pressure builds up on a fresh incision, it cannot keep the pressure and thus breaks.
  • Lifting heavy weights just after an operation leads to incisional hernia for the same reason as above, that is, building up of too much pressure on the incision.
  • Incisional hernia also results when you have multiple surgeries through the same incision.

What are the symptoms of incisional hernia?
The symptoms which result due to an incisional hernia are:

  • An infection around the wound portions is a common symptom.
  • You will be able to see a lump in the region where your last incision was done.
  • Bowel obstruction is seen in patients in whom an incisional hernia results in the strangulation of intestines.
  • An excruciating pain in the abdomen near the incision is also seen in complicated hernias.

What are the treatment options for incisional hernia?
An incisional hernia cannot be treated by any medications alone. You will have to go for a surgery to get relief from the condition. There are two types of surgeries that can help you repair the condition of incisional hernia and they are:

  • Open hernia repair – This treatment is also known by the name of hernioplasty. In this process, the surgeon will push back the protrusion inside your abdomen again and then seal the wall opening and reinforce it with a mesh.
  • Laparoscopic hernia repair – A small tube at the end of which a camera is attached is inserted inside your abdomen through a small incision and then the hernia is repaired. The surgeon can clearly watch everything inside your abdomen on a monitor.This surgery has minimal pain and the patient is usually discharged the next day.Return to normal activities happens in a week’s time.

What are the complications of incisional hernia?
Sometimes the hernias become massive and thus become difficult to operate. When the intestines protrude through the surgical wound, the can be pushed inside but it might result in blocking of those intestines. Strangulation of intestines can also occur due to a hernia which will slowly lead to damage intestines when the blood supply is cut off to them.


Authored By Dr G Parthasarathy - Surgical Gastroenterologist, Hyderabad