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Cartersville Surgical Associates, PC
970 Joe Frank Harris Parkway
Cartersville, GA 30120
Phone: 770.386.1261
Fax: 770.386.3873
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A ventral/incisional hernia is a defect in the abdominal wall at the site of a prior surgical incision. In large series investigating the prevalence of incisional hernia, these hernias are found in 10-30% of patients undergoing laparotomy. Risk factors for incisional hernia are: obesity, diabetes, collagen vascular disease, smoking, prior hernia, chronic cough or straining and infection.
Hernias usually present as pain or a bulge in the abdominal wall. The symptoms of pain may be more pronounced during times of lifting or physical exercise. Symptoms may also be exacerbated during times of sneezing or coughing. The bulge evident in the upright position, may go away when lying down. The pain may be sharp or a dull ache. If the intestinal tract becomes incarcerated within the defect, symptoms of obstruction such as nausea, bloating or vomiting may occur. If these symptoms occur, contact your physician immediately.
Ventral hernias have traditionally been repaired utilizing an open technique, most often an onlay prosthetic mesh repair. In this type of operation, a skin incision is made, the edges of the defect are identified and the fascia is reapproximated using permanent sutures. A synthetic material (mesh) is then used to cover the repair to lessen the chance of having a recurrent hernia. The risk of recurrent hernia formation with the open technique may be as high as 20-40%.
A more recent technique for hernia repair is laparoscopic ventral hernia repair. In this technique, a series of small incisions are made in the abdominal wall. Small trocars (cannulas) are inserted to allow instruments and a camera to be inserted into the abdominal cavity. The hernia is then repaired from the inside, securing mesh to the abdominal wall to cover the defect. The duration of the surgery varies according to the size of the defect and the extent of adhesions encountered at the time of the surgery. The recurrence rate is much less, on the order of 5-10%. Most patients are discharged the day following surgery and can return to light duty work within 7-10 days. Patients should do no lifting greater than 30 pounds for 4 weeks.
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