incisional hernia

Introduction

A hernia occurring through a surgical incision or scar.

Epidemiology

• 10-12% of abdominal incisions

Clinical manifestations

• generally occur in early postoperative period
• bulge in abdominal wall originating deep to the incisional scar
• discomfort
• cosmetic concern
• symptoms may be aggravated by coughing or straining
• protrusion of peritoneum through abbominal wall defect

Complications

incarceration of bowel

Management

• most should be repaired unless
  • small < 1 cm
  • large > 7-8 cm
  • upper abdominal & asymptomatic
• mesh repair
  • lower incidence of recurrence than sutured repair
  • mesh placed deep to fascia
• laparoscopic vs open repair

More general terms

• abdominal wall hernia (ventral hernia)