Description

An incisional hernia, also known as a ventral hernia, occurs when tissue or organs protrude through a weakened or previously surgically altered abdominal wall. It typically develops at the site of a previous surgical incision. Here is a detailed explanation of incisional hernia or ventral hernia: Causes: 1. Surgical Incisions: Incisional hernias most commonly occur following abdominal surgeries, such as those involving the removal of organs or procedures that require a large incision. The weakness in the abdominal wall can develop due to inadequate healing or excessive tension on the incision site. 2. Abdominal Trauma: Any injury or trauma to the abdominal wall, such as a deep wound or significant force impacting the area, can weaken the tissues and lead to the development of a ventral hernia. Risk Factors: Several factors may increase the risk of developing an incisional hernia: • Obesity: Excess weight puts added strain on the abdominal wall. • Infection: Postoperative infections can impair proper healing of the incision site. • Poor Wound Healing: Conditions that interfere with wound healing, such as diabetes or smoking, increase the risk of hernia formation. • Chronic Cough: Persistent coughing or sneezing can strain the abdominal muscles. • Malnutrition: Inadequate nutrition can weaken tissues and impair healing. • Age: Older individuals may have decreased tissue elasticity and muscle strength. • Connective Tissue Disorders: Conditions that affect the connective tissues, such as Ehlers-Danlos syndrome, may contribute to hernia development. Symptoms: The symptoms of an incisional hernia or ventral hernia may include: • A bulge or swelling at the site of the previous surgical incision. • Discomfort or pain, especially during physical activities or when lifting heavy objects. • Pressure or a feeling of heaviness in the abdomen. • Digestive symptoms, such as nausea, vomiting, or constipation, if the hernia is large and affects the intestines. Diagnosis: The diagnosis of an incisional hernia or ventral hernia typically involves a combination of a physical examination and imaging tests, such as ultrasound, CT scan, or MRI. The healthcare professional will evaluate the size, location, and contents of the hernia and assess the risk of complications. Treatment: The treatment of an incisional hernia or ventral hernia usually involves surgical repair. The goals of surgery are to close the hernia defect and reinforce the weakened abdominal wall. The surgical options include: • Primary Closure: In cases where the hernia defect is small and the surrounding tissues are healthy, the surgeon may directly suture the edges of the defect together to close it. • Mesh Repair: For larger hernias or cases where the tissues are weak, a synthetic mesh may be used to reinforce the area. The mesh is placed over the hernia defect and secured in position with sutures or surgical staples. The body's tissues gradually grow into the mesh, providing additional strength to the repair. Postoperative care involves wound care, pain management, and gradual return to normal activities. Regular follow-up appointments with the healthcare professional are essential to monitor the healing process and detect any recurrence or complications. It's important to consult with a healthcare professional, usually a general surgeon or hernia specialist, to determine the most appropriate treatment plan for an incisional hernia or ventral hernia. The individual's specific condition, including the size and location of the hernia, overall health, and any underlying risk factors, will be considered to provide optimal care. AWR (Abdominal Wall Reconstruction) is a modern approach to the surgical repair of complex incisional hernias. AWR involves a comprehensive and multidisciplinary approach to reconstructing the abdominal wall and addressing the underlying causes of the hernia. Here is an overview of some modern repair techniques used in AWR: Component Separation Technique: This technique involves releasing and mobilizing the layers of the abdominal wall, allowing for the advancement of healthy tissue to close the hernia defect. It helps to restore the integrity and strength of the abdominal wall. Mesh Placement: Synthetic mesh materials are commonly used in AWR to provide additional support and reinforcement to the repaired abdominal wall. The mesh is placed either on the front (onlay) or within the layers of the abdominal wall (sublay) to provide strength and prevent recurrence. Ventral Hernia Repair with Transversus Abdominis Release (TAR): TAR is a technique used to repair large and complex ventral hernias. It involves the release of the transversus abdominis muscle from its attachments, allowing it to slide over the defect and close the hernia. Mesh reinforcement is often used in conjunction with TAR.