Introduction
An incisional hernia is a condition where abdominal organs or tissues protrude through a weakened area in the abdominal wall, typically at the site of a previous surgical incision. This can occur after a surgical procedure when the incision site does not heal properly, leading to a weakness in the surrounding tissues and allowing abdominal contents to bulge through the opening.
Indications
Some common indications include:
- A visible bulge or swelling at or near a previous surgical incision.
- Pain or discomfort, especially during physical activity or lifting.
- Difficulty with bowel movements or passing gas.
- Nausea and vomiting.
- Hernia enlargement or symptoms worsening over time.
Preoperative Instructions
Before undergoing incisional hernia repair, patients need to follow specific instructions to ensure successful surgery and reduce the risk of complications. Preoperative instructions may include fasting, medication review, smoking cessation, and arranging transport from the hospital.
Procedure
The incisional hernia repair is usually performed under general anaesthesia and will be either open or laparoscopic.
Open Repair: Dr Moar will make an incision directly over the hernia, repositioning the protruding tissue back into the abdominal cavity, and reinforce the weakened area with sutures and/or a mesh implant.
Laparoscopic or Robotic Repair: In these minimally invasive approaches, several small incisions are made, and a laparoscope (a thin, lighted tube with a camera) and surgical instruments are used to repair the hernia. A mesh may also be used for reinforcement.
Postoperative Instructions
After incisional hernia repair, common postoperative guidelines include:
- Rest and Recovery: Take ample rest and avoid strenuous activities as advised by the surgical team.
- Pain Management: Take prescribed pain medications to manage post-surgery discomfort.
- Wound Care: Keep the incision site clean and dry, following instructions on dressing changes.
- Diet: Gradually reintroduce a balanced diet and stay hydrated. Follow any dietary restrictions provided by Dr Moar.
- Avoid Straining: Refrain from heavy lifting or activities that may put a strain on the surgical site.
- Follow-up Appointments: Attend all scheduled follow-up appointments with Dr Moar to monitor the healing process.
Risks
While incisional hernia repair is generally safe, there are some potential risks and complications associated with the procedure, including infection at the surgical site, adverse reaction to anaesthesia, recurrence of the hernia, nerve damage, or damage to other nearby structures such as the bowel. There is also a risk of mesh-related complication, or hematoma or seroma formation, where blood or fluid collects at the surgical site.
Treatment Alternatives
Treatment alternatives for incisional hernia repair depend on the individual case and may include watchful waiting, support garments, and lifestyle and activity changes.