Ventral/ Incisional Hernia
- A ventral hernia, can occur at any potential site of abdominal wall weakness. Scars arising from previous abdominal surgeries usually are areas of weakness where such hernias can develop .Hence, majority of ventral hernias arising from previous abdominal incisions or scars are also called as incisional hernias.
- This type of hernia usually results either because of technical failure i.e. improper closure of the muscles during surgery or breakdown of surgical sutures or weakening of the surrounding muscles over a period of time due to previous surgery.
- An incisional hernia can occur immediately following surgery, or may not become apparent for years.
- Hernias of this type are often accompanied by a swelling or bulge near the area of the prior incision.
- Pain may be an early warning sign of an incisional hernia, as there may not be any initial presence of a bulge.
Treatment of Ventral Hernia
- Surgery to fix these types of hernias can be done in various ways and techniques. Our team has a very vast experience for treatment of ventral hernia both by minimally invasive or laparoscopic surgery as well as the traditional open approach.
- It is after proper evaluation of the patient , we offer the best possible options for the optimal results and permanent cure for the problem.
- The various procedures available for the management of incisional hernia
Conventional Open repair for simple abdominal wall hernia
In simple incisional hernia repair, small cut is made over the previous incision. The herniated tissue is pushed back inside and then the mesh is placed against the interior abdominal wall. The entire area is then reinforced and strengthened by extending the mesh so it reaches well beyond the hernia’s edge.
Laparoscopic surgery for ventral hernia
- The laparoscopic or minimal invasive approach nowadays has emerged as the best and most advanced treatment for ventral hernia.
- Also known as” intra peritoneal onlay mesh” repair, this technique involves placing 3 small cuts or incisions about 1 cm in size. A telescopic camera is introduced along with long thin instruments and the hernia contents are reduced.
- The entire weakened area is then reinforced with the help of composite mesh so as to prevent recurrence.
- Similar to umbilical hernia, we advocate the use of composite mesh to prevent bowel adhesion in later stages.
- Laparoscopic surgery offers faster recovery, less pain and even the chances of recurrence of hernia are reduced.
Component separation technique for complex hernia
Complex abdominal hernia result from incisional hernia related to multiple abdominal operations, surgical resection of the abdominal wall or loss of abdominal wall due to severe infections.
The component separation technique is used to treat complex abdominal hernias or defects i.e. when there is insufficient muscular wall that can be pulled back together during a conventional hernia repair.
These defects are so large that reinforcement alone with mesh will not yield good results and can be associated with very poor quality of life.
Component separation involves separating and advancing certain layers of the abdominal wall muscle, lengthening them so that the right and left sided muscles can be brought closer to the mid-line for sufficient closure.
This technique restores the structural and functional integrity of the abdominal wall and as well optimizes aesthetic appearance. A combination of component separation and mesh repair is frequently used to repair giant abdominal wall hernias. It is a complex procedure that is best done in the hands of experienced surgeons and if done properly ensures long lasting results.