What is an incisional hernia?1,2
An incisional hernia forms when an intestine, organ, or other tissue pushes through weakened abdominal muscle at, or near, a previous surgical site. Incisional hernias occur in about one out of every three patients after abdominal surgery, even though they represent only 10% of all hernias.3 These hernias result from a weakening of the abdominal muscle due to a surgical incision and often occur three to six months post-surgery (but can happen at any time).
What are the common symptoms of an incisional hernia?2
Small incisional hernias (about 2 inches wide or long) may not cause any symptoms, however, incisional hernias of average or larger size (4+ inches) typically create a bulge near the previous incision site and may be painful.4 They are often visible when you stand up, cough, or strain. They may also cause:
- Constipation and/or thin, narrow stool
- Nausea and vomiting
- Abdominal pain near the bulge
- Quickened heart rate
- Fever
What is the cause of an incisional hernia?
Incisional hernias happen when the surgical cut in your abdominal wall doesn’t fully close or heal after surgery. This can cause your abdominal muscles to weaken and allow a section of intestine or tissue to bulge through.1
Several risk factors may increase your chances of developing an incisional hernia after surgery, including:2
- Excessive or premature physical activity after surgery
- Gaining considerable weight
- An increase in abdominal pressure
- Becoming pregnant
- Wound infection
- Pre-existing health conditions
- Smoking
- Certain medications
How is an incisional hernia diagnosed?5
Your healthcare provider will review your medical and surgical history and provide a physical exam where they will check your abdominal area. You may be asked to stand, strain, or cough to cause the hernia to bulge. Your doctor may order imaging tests to help assist in the diagnosis using:
- Ultrasounds
- Computer tomography (CT) scans
- Magnetic resonance imaging (MRI) scans
Learn more about hernia diagnosis →
How is an incisional hernia repaired?4
The right treatment can depend on your symptoms—or lack thereof. Smaller incisional hernias that don’t hurt or bother you may not require surgery. However, incisional hernias may get bigger over time, and having a large hernia increases your risk of complications. If you have a large hernia or it causes symptoms, a surgeon will opt to do hernia repair surgery.
How is repair surgery performed for an incisional hernia?
There are three primary surgical options for incisional hernia repair: open, laparoscopic, and robotic. The appropriate type of surgery for you may depend on the size, severity, and location of your hernia. Ask your doctor about which option is right for you.
Open Surgery: As the traditional surgical method, an open surgical procedure involves making a large incision over the area of the hernia. The hernia bulge is returned to its correct position, and a mesh is often placed to help strengthen and support the weakened area before closing up the incision.
Laparoscopic Surgery: A surgeon will use several small, ‘key-hole’ sized incisions during laparoscopic surgery. Instruments, such as a camera, are then inserted through the incisions to perform the operation.
Robotic Surgery: Like laparoscopic surgery, robotic surgery uses several smaller incisions. The surgeon will perform the operation from a console located in the operating room.
Learn more about modern surgical techniques.
Seeking care for your incisional hernia
If you have symptoms of an incisional hernia, it’s important to meet with a healthcare provider as soon as possible to have it diagnosed. You can utilize this Doctor Discussion Guide to help walk you through important questions to ask your doctor during your consultation.
The guidance provided in this article follows general rules that should be discussed with your doctor. This article is for informational and educational purposes only. It does not substitute for medical advice. If in doubt, always consult your doctor.
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Related Articles
References
- https://www.healthline.com/health/incisional-hernia#causes
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/hernias/incisional-hernia
- https://my.clevelandclinic.org/health/diseases/15757-hernia
- https://my.clevelandclinic.org/health/diseases/incisional-hernia
- https://www.brighamandwomens.org/surgery/general-and-gastrointestinal-surgery/hernia/incisional-hernia
This site is not intended as a substitute for professional medical care. Only your physician can diagnose and appropriately treat your symptoms. BD does not recommend the use of any particular physician or team of physicians. Please consult your healthcare provider for advice regarding who should be part of your hernia repair team.
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