Hernias are one of the most common surgical conditions.
Yet it’s the kind of condition many people will live with and worry about whether to seek specialist advice.
If there’s anything you’re unsure about or have questions about, it’s always best to seek specialist medical advice.
The following are frequently asked questions which may be of benefit to you.
WHAT IS AN INCISIONAL HERNIA?
An incisional hernia is a hernia which develops in a previous surgical wound. They are very common and can range from a tiny defect in the abdominal wall to complete disruption over the whole length of the incision. They present mainly as an unsightly swelling of the wound but in common with other hernias may also be uncomfortable or indeed present with severe pain.
DO INCISIONAL HERNIAS REQUIRE TREATMENT?
Small asymptomatic hernias can be managed without surgery but as it is common for these hernias to enlarge and become uncomfortable it is better to seek a specialist opinion.
WHAT ARE THE TREATMENT OPTIONS?
It is sometimes possible to manage these hernias with an abdominal corset rather than have surgery but this is for comfort only and does not resolve the underlying problem. Small hernias can be treated in the same way as umbilical hernias, preferably with the use of mesh to reduce the possibility of recurrence. Larger hernias can present a very complex problem in terms of trying to obtain long term cure and the recurrence rate can be as high as 25% or more depending on the particular hernia and the health of the patient. A detailed discussion with a specialist is necessary to determine the best treatment option for each individual but may include repair using a sutured technique, placement of a mesh or using a keyhole approach. There are pros and cons to each technique and you will need to give careful consideration to each, guided by your specialist.
WHAT KIND OF RECOVERY CAN I EXPECT FOLLOWING SURGERY?
Many of these hernias are large and require a lot of surgical dissection to treat adequately. Therefore, it can be expected that recovery is often slow and uncomfortable. Unfortunately, wound complications are common after repair of incisional hernias often because the risk factors for developing an incisional hernia also contribute to a higher risk of infection including obesity, diabetes and steroid treatment for other conditions. Smaller incisional hernias will generally have a lower postoperative complication rate and a smoother recovery. Many of these hernias are suitable for a keyhole approach to repair by placing a mesh over the defect from within the abdomen using small incisions. The recovery following keyhole repair is much quicker and more comfortable than using the standard approach of making an incision over the swelling on the abdominal wall. Suitability for keyhole repair will require discussion with your specialist.
WHAT ARE THE COMPLICATIONS OF REPAIRING INCISIONAL HERNIAS?
Complications include infection, hernia recurrence and mesh removal. With larger hernias it is not uncommon to have minor wound healing problems which require multiple attendances to outpatients for repeated dressings until healing. With keyhole surgery the risks are similar but there is an additional though rare, risk of damaging internal organs which may require further surgery to correct.