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Incisional Hernia

What is an incisional hernia?

These are ventral hernias caused by previous surgical incisions or trauma. They often occur when the healing conditions were not ideal around the time of the original surgery, such as wound infection, obesity, smoking, the underlying reason for the surgery, and sometimes just happen because of surgical technique.

Hernias usually cause a swelling or bulge that comes and goes and an ache. They do not in themselves cause severe pain, but a complicated hernia or a hernia with a torn muscle or irritated nerve can cause pain. A complicated hernia is one which is stuck, and the contents could be dying and surgery is more urgent of course. Strangulation, where the contents are dying or dead, is an uncommon but potentially dire complication of a hernia.

Hernias never repair themselves. Surgery is the only way to repair hernias. All people with a hernia who are fit for surgery should consider having the hernia repaired sooner rather than later to prevent an urgent operation.

Hernia

 

What operations are there?

There are 3 main surgical methods to repair a hernia: Open Suture, Open Mesh, and Laparoscopic Mesh Repair. Each has their merits.
Open suture repair is simply suturing the muscle defect with as many sutures as required. This is done via an incision made in the skin over the hernia.

Open mesh repair often involves re-suturing the defect and then buttressing this with a piece of mesh for added strength, or uses mesh alone to cover the defect which is sutured in position. This also involves making an incision in the skin over the hernia.

Incisions - Hernia

 

Operative Risks

For any operation there are risks, and in particular there is a risk of infection, bleeding and injury. The overall risk of major complications is less than 1%. The specific risks in laparoscopic hernia repair are bleeding (1 in 500) and injury to abdominal structures or organs (1 in 500). Surgery is required generally to repair these, and sometimes extensive surgery. The risks of the surgery are greater if there is scar tissue from previous surgery or conditions that have resulted in the matting down of adjacent structures. The most common outcome is no complications or a minor problem that will pass such as wound infection (5%).

Mr Draper has performed over 1000 laparoscopic hernia operations with 0.1% complications and 1% recurrence rate. All figures are approximate.

 

Post Operative Recovery

Most people are ready to go home 1 or 2 days post surgery and need 2 weeks convalescence before returning to work. Postoperative problems such as pain and nausea are usually easily managed. The time takenesuming your usual level of activity is not easy to predict, as it depends on your background level of fitness, amount of pain and what you want to resume doing. As a general guide it takes about 2 weeks for most people to return to work, gradually reintroducing activities as tolerated.

 

More Information

This brief information sheet is best considered a reference to be used in conjunction with discussions with your surgeon. For further information discuss your operation in detail with your surgeon, visit our website geoffreydraper.com.au, or read other relevant information sheets such as Laparoscopic Inguinal and Femoral Hernia Repair or our Patient Advice Sheet.

 

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