This Hernia occurs through a single or multiple gaps in the scar of previous surgery. This happens due to one or multiple factors. Lack of adequate healing, increased pressure on wound in early days, infection of stitches, or rarely improper technique of closure can result in incisional Hernia.
- The fat (omentum) or intestines starts from protruding out of these defects and slowly enlarges in size. Overtime it gets stuck inside the sac.
- Like umbilical Hernia, this also can get obstructed or if blood supply in hampered the part of intestine can die and present as Gangrene.
- Surgery can be done by open or Laparoscopic technique, very similar to umbilical Hernia.
- However,Incisional Hernias are more difficult to tackle since
- There can be multiple defects
- The Hernia tends to be larger
- The intestines are badly stuck
- The mesh needs to be much larger than defect to present recurrence
- Recurrence rate is higher than other hernias.
- The abdomen is inflated by CO2 gas. The adhesions to previous scar are released.
- The omentum, intestines stuck inside the Hernia are released and put back in abdomen. The defect or defects are closed with suture. If the defect is too large,it may not be possible to close it.
- A large dual mesh is put inside and spread across the hernia site to cover it from all sides. It should be at least 5cms larger than defect from all sides. The mesh is fixed with sutures going through abdominal wall and special screws called tacks. These screws can be absorbable.
- complications are similar to Umbilical Hernia.