An incisional hernia, as the name suggests, occurs at the site of a previous incision and develops in the abdominal wall.
This type of hernia is typically a result of the muscles of an old incision breaking down. An incision in your abdominal wall will always be an area of potential weakness and although rare, when the incision breaks down an incisional hernia develops.
Incisional hernias can range in size from very small to large and complex and are often identifiable as a bulge at or near the area of prior incision. Nearly any prior abdominal operation can develop an incisional hernia, however, they most frequently occur along incisions running down from the breast bone to the pubic area. Some procedures which can result in an incisional hernia are intestinal surgery, vascular surgery, an appendectomy or laparoscopy. Incisional hernias can be a result of tension placed on the tissue from the prior surgical procedure, disruption in the general area of prior suturing to the abdominal wall or inadequate healing, which can be due to obesity, metabolic diseases, infection or poor nutrition.
A bulge may not be visible at first and pain, sharp or a dull ache, may be early warning signs. Relentless discomfort or nausea related to any type of abdominal bulge may be a sign that the hernia has become strangulated or incarcerated (PHOTO of Incarcerated Incisional Hernia). If you are experiencing these similar symptoms, contact a doctor immediately. An incisional hernia can occur immediately following surgery or may not become apparent for years after the procedure. These types of hernias can develop at the site of a previous incision due to injury or infection following surgery, heavy straining or with age.
Since suturing (tension) can be the cause of some incisional hernias, it is highly advised that incisional hernias be repaired with the "tension free" mesh technique to avoid future recurrence. Unfortunately, many surgeons still use older "tension" techniques, which involved attaching tissue to tissue with sutures only. This older technique not only creates tension but is often the reason the hernia occurred in the first place. At the Hernia Center of Southern California, we practice only the highly advanced "tension free" mesh technique. We realize that by attaching tissue to tissue and repairing the hernia with only sutures more tension is created on an already weakened area. Reinforcing and strengthening the weakness so it may withstand years of wear and tear on your body is our goal and the reason we practice the "tension free" mesh technique.
With the "tension free" mesh technique thin, flexible, polypropylene mesh is placed underneath the flaw in the abdominal wall. By extending the mesh so it reaches well beyond the edges of the entire flaw we are able to reinforce the entire area, and then some, as well as strengthen it. Internal organs are protected as well by a natural forming membrane, "peritoneum", which diminishes the possibility of anything adhering to the intestine.
Large and/or complex incisional hernias often require general anesthesia instead of local anesthesia. We also recommend a comprehensive examination and evaluation to correctly outline the operational approach with large and/or complex incisional hernias. We advise our patients who travel from other regions of the country and abroad to have an initial phone consultation with one of our surgeons prior to scheduling consultation and/or surgery.