Understanding Incisional Hernias

An incisional hernia occurs when tissue or part of an organ, such as the intestine, protrudes through a weakened area in the abdominal wall after surgery. Surgical incisions disrupt the abdominal muscles, so the repaired tissue may become vulnerable to internal pressure over time, increasing the chance of a hernia forming.

Incisional hernias can vary in size and severity—from small, painless bulges to larger, more complex protrusions that cause discomfort, pain, or potential complications. Studies estimate they develop in 10-15% of cases, with risk factors including the patient’s health, type of surgery, and recovery process.

What Are Common Incisional Hernia Symptoms?

Incisional hernias typically develop near a previous surgical site. If you’ve had abdominal surgery, recognizing incisional hernia symptoms early can help ensure the best treatment and outcome.

Common signs to watch for include:

• Visible bulge: You may notice a soft lump near the incision site, which may become more noticeable when standing, coughing, or straining.
• Pain or discomfort: This can range from mild to severe, especially with lifting, bending, or coughing.
• Pulling or pressure: Some may experience a sensation of tugging in the affected area, even without pain.
• Swelling or tenderness: The site may feel sore, especially if the hernia is under strain.
• Worsening symptoms with activity: You may notice increased pain or bulging with prolonged standing or heavy lifting.
• Changes in bowel habits: In severe cases, nausea, vomiting, constipation, or difficulty passing gas may occur.
• Redness or warmth: If the hernia becomes trapped or strangulated, the area may become inflamed, signaling a medical emergency.

If you experience persistent pain, a growing bulge, or digestive issues, seek medical care promptly to avoid complications.

Causes and Risk Factors of Incisional Hernias

While anyone who has undergone abdominal surgery can develop an incisional hernia, certain factors increase the risk. They are more likely to occur if the incision is subjected to excessive strain before fully healing. This can happen due to:

• Strenuous activity too soon after surgery: Lifting, bending, or intense movement before full recovery can stress the healing tissues.
• Significant weight gain or pregnancy: Increased abdominal pressure can weaken the incision site.
• Chronic coughing or straining: Conditions that cause frequent coughing, constipation, or heavy lifting can contribute to hernia formation.

Incisional hernias most often develop within three to six months after surgery, but they can appear anytime. If you notice a bulge, discomfort, or changes in bowel habits near your surgical site, early evaluation is key to preventing complications.

Treatment Options for an Incisional Hernia

Incisional Hernia Repair Surgery

Our surgeons utilize one of three approaches to repair an incisional hernia. The right one for you will depend on the size of the hernia, its location, and your overall health.

• Open Surgery: A traditional approach that involves making an incision directly over the hernia site to repair the abdominal wall. This method allows for direct visualization and may be preferred for larger or more complex hernias.
• Laparoscopic Surgery: A minimally invasive technique using small incisions and a tiny camera to guide the repair. This approach typically leads to less pain, a faster recovery, and smaller scars than open surgery.
• Robotic-Assisted Surgery: A more advanced, minimally invasive approach that provides surgeons with greater precision and flexibility. This method can be particularly useful for complex or hard-to-reach hernias and may further reduce recovery time.

In many cases, a surgical mesh is used to reinforce the abdominal wall, reducing the risk of recurrence and strengthening the repair.

Are There Non-Surgical Options?

While surgery is the most effective and recommended treatment, some patients may consider temporary measures, including:

• Watchful Waiting: In rare cases, small, symptom-free hernias may be monitored, though this presents risks.
• Supportive Devices: Abdominal binders can help reduce discomfort while awaiting surgery.
• Lifestyle Adjustments: Maintaining a healthy weight, avoiding heavy lifting, and managing chronic conditions (like coughing or constipation) can help prevent worsening symptoms.