Incisional Hernia Repair or Ventral Hernia Repair
An incisional hernia is hole within the site of an earlier surgical incision.
A ventral hernia or incisional hernia is a hole in the abdominal wall behind or within the site of an earlier surgical incision. Because of the hole, the contents of the abdominal cavity, such as intestines, can spill out behind the skin, creating a bulge.
Ventral hernias or incisional hernias can occur in men, women or children, and they occur along the midline of the abdomen. They frequently occur at the point of a prior incision, if you have had an abdominal surgery procedure in the past. The hernia surgeons at Hernia Center Los Angeles specialize in the diagnosis and treatment of incisional hernias and ventral hernias.
What causes a ventral or incisional hernia?
Sometimes, ventral hernias can occur naturally, through areas of the abdominal which may be naturally weaker, or strained and pulled by pregnancy. If you have had prior surgery, then the fascia (connective tissue), which is the strength component of the abdominal wall, may have healed poorly.
This can happen for many reasons. The most common reason is infection after the surgery. Other factors can also lead to a hernia, though, including extensive coughing, heavy lifting, obesity, returning to normal activity too soon after surgery, or a physical tendency that predisposes some patients to develop hernias.
What procedures are available for my ventral hernia repair?
The best incisional hernia repair Los Angeles has for you will depend on the exact nature of your hernia. Ventral hernias may be simple, such as just a small hole in the abdominal fascia. In this case, our surgeons recommend repairing the hernia by returning the bowel to its proper location, and then closing the hole in the abdominal wall. In many cases, an underlay mesh is used, which is placed to remove tension from the abdominal wall during closure. This gives the abdominal wall a chance to heal well in a tension-free environment, which is the key to a successful outcome.
Sometimes, patients with a ventral hernia have an underlying condition called “rectus diastasis” or abdominal muscle separation. This can occur in both men and women, but is especially common after pregnancy. The muscles on either side of your abdomen -- the ones that make up your “six pack” are called the rectus muscles. They normally join at your midline, adjacent to your navel. These muscles can separate or stretch apart, called a diastasis. You can tell you have a rectus diastasis because you will notice your abdomen bulges easily after meals, it is difficult to “suck it in”, and your abdominal strength is reduced.
If your ventral hernia includes rectus diastasis, your abdominal muscles need to be repaired. The separation of the muscles creates a natural weakness of the abdominal wall, so repairing of the muscles at the same time as the hernia repair will decrease the recurrence rate, be a stronger repair, and will increase the strength of your entire core.
What if my child has a ventral hernia?
If your child develops a ventral hernia, you should get it repaired promptly. Ventral hernias do not close on their own. The longer that your child’s hernia remains, the more dangerous it becomes. If a portion of your child’s bowel slips through the hole in the abdominal wall and becomes trapped, it can lead to a bowel obstruction and require emergency surgery.
In a child, the procedure for repairing a ventral hernia is usually very simple. The hole is closed with sutures, and the abdominal muscles grow back together as the child grows.
Should I have a mesh repair for my ventral hernia repair?
You may have heard of a “mesh” hernia repair, or know someone who has gotten one. While surgical mesh is an excellent surgical tool for some types of hernia repairs, our reconstructive surgeons recommend mesh only if it is necessary to add strength to the repair.
“Overlay” mesh repair is never recommended by our surgeons. In this type of approach, surgical mesh is used to cover the hole in the abdominal wall on the outside of the hernia sac, much as you would patch a hole in a tire. Rather than returning your abdominal wall muscle to its natural state, a fix of this type just covers the area of weakness. Future strain or expansion could stretch the hole beyond the patch, pulling it loose and causing the hernia to return.
Overlay mesh repair has a high failure rate. Over 50% of overlay mesh repairs result in a recurrence of the hernia.
Our surgeons may recommend that an “underlay mesh” be used as part of your hernia repair. In this case, after returning the bowel to its proper location, mesh may be placed on the underside of the tear to reinforce the repair and remove tension from the abdominal wall during closure. This gives the abdominal wall a chance to heal well without extra strain or tension.
During your surgical consultation, your surgeon will explain to you all of the possible options that you have for repairing your hernia, as well as his or her recommendation for the best ventral hernia repair available for you.
Find out about your incisional hernia repair options today
If you have a ventral hernia or incisional hernia, don’t wait. Have it repaired on your own schedule, in our comfortable surgical facilities at Hernia Center Los Angeles. You don’t want to let it turn into an emergency situation.
