Incisional Hernia

An incisional hernia occurs when tissue bulges out through a weakened spot in the abdominal wall, typically at the site of a previous surgical incision.

Incisional hernias can cause pain, discomfort, and complications if left untreated.

Accurate diagnosis and appropriate treatment are essential for effective management and recovery.

What is an incisional hernia?

An incisional hernia develops when tissue, such as intestines or fat, bulges through a weakened area in the abdominal wall at the site of a previous surgical incision.

These hernias can occur months or years after the initial surgery and are more common in the abdomen area.

They can vary in size and severity, ranging from small, painless bulges to larger hernias that cause significant discomfort and complications.

Learn more: What is a hernia?

Incisional hernia causes

Several factors can contribute to the development of an incisional hernia:

Surgical-related factors

• Poor surgical technique: Inadequate closure or weakness at the incision site can lead to hernia formation.
• Postoperative complications: Infections or complications that compromise the integrity of the incision site.

Patient-related factors

• Obesity: Excess weight can place additional pressure on the abdominal wall, increasing the risk of hernias.
• Age: Older adults are more prone to developing hernias due to weakened muscles.
• Smoking: Smoking impairs wound healing and increases the risk of hernia formation.
• Chronic illnesses: Conditions such as diabetes and chronic obstructive pulmonary disease (COPD) can affect healing.

Lifestyle factors

• Heavy lifting and strenuous activities: Activities that strain the abdominal muscles can exacerbate a weakened incision site.
• Persistent coughing or straining: Chronic cough or straining during bowel movements can increase intra-abdominal pressure, leading to hernias.

Incisional hernia symptoms

Symptoms of incisional hernias can vary, but may include:

Noticeable bulge

• Visible protrusion: A bulge or swelling at the site of the previous surgical incision, which may be more apparent when standing or straining.

Pain and discomfort

• Localized pain: Pain or tenderness at the hernia site that may worsen with physical activity or heavy lifting.
• Discomfort: A feeling of heaviness or discomfort in the abdominal area.

Digestive symptoms

• Nausea and vomiting: If the hernia obstructs the intestines, it can cause nausea and vomiting.
• Changes in bowel habits: Difficulty with bowel movements or constipation due to hernia-related obstruction.

Incisional hernia diagnosis

Diagnosing an incisional hernia involves a thorough medical evaluation, including:

Medical history

Your doctor will inquire about your surgical history, symptoms, and any activities that may contribute to hernia formation.

Physical examination

A physical exam will involve inspecting and palpating the hernia site to assess the size, location, and severity of the hernia.

Imaging tests

If necessary, additional tests such as these may be performed:

• Ultrasound: To visualize the hernia and assess its contents.
• CT scan or MRI: Detailed images to evaluate the hernia and surrounding tissues for complications.

Incisional hernia treatment

Treatment for incisional hernias depends on the size, severity, and symptoms of the hernia, and may include:

Conservative treatments

• Watchful waiting: Small, asymptomatic hernias may be monitored if they do not cause significant discomfort or complications.
• Lifestyle modifications: Avoiding activities that strain the abdominal muscles, weight management, and smoking cessation.

Medical treatments

• Pain management: Over-the-counter or prescription medications to relieve pain and discomfort.
• Binding or support garments: Use of abdominal binders or support garments to reduce symptoms.

Surgical treatment

If conservative measures are ineffective or if the hernia poses a risk of complications, surgery may be necessary:

• Open hernia repair: The hernia is repaired through a larger incision, with reinforcement using sutures or a mesh.
• Minimally invasive hernia repair: Minimally invasive surgery using small incisions and a camera, with mesh reinforcement to strengthen the abdominal wall.

Learn more: 11 things to do before surgery>>

Incisional hernia prevention

Preventing an incisional hernia involves adopting healthy habits and lifestyle modifications:

Postoperative care

• Proper wound care: Following postoperative instructions for wound care to promote healing.
• Gradual return to activities: Gradually resuming physical activities, avoiding heavy lifting and strenuous exercises initially.

Healthy lifestyle

• Weight management: Maintaining a healthy weight to reduce pressure on the abdominal wall.
• Healthy diet: Eating a balanced diet to support overall health and healing.
• Avoid smoking: Quitting smoking to improve wound healing and reduce hernia risk.
• Exercise: Incorporating regular exercise to strengthen the abdominal muscles, with guidance from a healthcare professional.

If you suspect you have an incisional hernia or have been diagnosed with the condition, seeking medical advice from a health care professional is essential.

With appropriate treatment and lifestyle adjustments, incisional hernias can be effectively managed or fixed, enhancing your quality of life.