Incisional
Hernias

What is an Incisional Hernia?

An incisional hernia occurs when part of the intestine or abdominal tissue pushes through the abdominal wall at the site of a previous surgical incision.
It often appears as a visible bulge near the old surgical scar, especially when bending, coughing, or lifting something heavy.
In some cases, the bulge may remain visible even while standing or lying down.

What are the symptoms of Incisional Hernia?

  1. Visible Bulge or Lump:
    A soft swelling or bulge near the old surgical scar is the most common sign.
    It often becomes more noticeable when you stand, cough, lift something heavy, or strain your abdominal muscles — for example, while passing stools if you’re constipated.
  2. Pain or Discomfort:
    You may feel a sharp or dull aching pain around the bulge.
    The pain often increases when you lift heavy objects, cough, or sneeze.
incisional-hernias

When should you see your doctor immediately?

When you have these Warning Symptoms of incisional hernia like:

  • Sudden abdominal bloating or tightness
  • Sharp, worsening, or continuous abdominal pain
  • Bulge that becomes red, dark, or firm to touch
  • Nausea, vomiting, or blood in stools
  • A hernia that was previously soft and reducible (could be pushed back in) becoming hard and irreducible

What causes an Incisional Hernia?

Incisional hernias can develop after open abdominal (laparotomy) or minimally invasive surgeries.
After surgery, the abdominal muscles need time to heal. If they weaken or don’t heal properly, tissues can push through the incision site.

Factors that increase the risk include:

  • Being physically active too soon after surgery
  • Wound or surgical site infection
  • Obesity
  • Diabetes
  • Chronic cough (asthma, COPD, bronchiectasis)
  • Constipation or straining during bowel movements
  • Urinary problems causing straining
  • Long-term use of steroids or immunosuppressants

➡️ Around 20% of people who undergo laparotomy may develop an incisional hernia, sometimes months or years after surgery.

How is an Incisional Hernia diagnosed?

Your doctor may recommend:

  • Clinical examination: To feel the hernia and assess its reducibility and tenderness.
  • Ultrasound abdomen: To measure the size of the hernia defect and check for any other abnormalities in the abdomen.
  • CT scan of the abdomen: Used in complex, recurrent, or large hernias, or when complications like obstruction or strangulation are suspected.

Can medicines cure an Incisional Hernia?

No. Medicines cannot repair the muscle defect. Since an incisional hernia is a structural problem in the abdominal wall, surgery is the only effective treatment.

What are the treatment options available for Incisional Hernia?

Since an incisional hernia is a mechanical defect in the abdominal wall, surgery is the only effective treatment. Medicines cannot repair the muscle gap or push the herniated contents back into the abdomen.

Before surgery, your doctor will evaluate and manage any underlying causes — such as chronic cough, constipation, infection, or obesity — to ensure proper healing and reduce the risk of hernia recurrence after the operation.

What is the surgical treatment for an Incisional Hernia?

The standard surgical procedure for an incisional hernia is a Mesh Repair – open or laparoscopic (keyhole surgery)
During the operation, the surgeon carefully opens the hernia sac, returns the protruding tissues or intestines back into the abdomen, closes the muscle defect, and then reinforces the area with a non-absorbable surgical mesh to provide additional strength and prevent recurrence.

How is it done?

This procedure can be performed either laparoscopically (keyhole surgery) or through open surgery, depending on the size of the hernia, the patient’s medical condition, and the complexity of the case.

incisional-hernias

What is laparoscopic mesh repair?

It’s a simple surgery done by using laparoscopy and 3 pin hole incisions(cuts). The hernia is reduced from inside and mesh is placed inside intraperitoneally.

Who can undergo laparoscopic mesh repair?

Patients who are medically fit to receive general anaesthesia are good candidates for laparoscopic repair.

What are the advantages of laparoscopic mesh repair?

  • Minimal pain and discomfort
  • Tiny, nearly invisible scars
  • Short hospital stay (usually 1–2 days)
  • Quick return to work and normal activities
  • Very low recurrence rate

Who Can Undergo Open Surgery?

Open surgery is recommended in specific situations where laparoscopic repair may not be suitable. These include:

  1. Medically high-risk patients – Individuals with serious lung (respiratory), heart (cardiac), or liver (cirrhotic) conditions, where general anaesthesia poses a significant risk.
  2. Complicated or recurrent hernias – Cases involving strangulated or gangrenous bowel, large or multiple previous hernia repairs, or when extensive scar tissue makes laparoscopic access difficult.

What is done in complicated cases of Incisional Hernia?

In complicated cases of incisional hernia, where a portion of the intestine becomes trapped (strangulated) and loses its blood supply, emergency surgery is required.
During the procedure, the non-viable (dead) section of the intestine is carefully removed (bowel resection), and the healthy ends are stitched back together to restore normal intestinal continuity.

Prompt medical attention is crucial, as delayed treatment can lead to severe infection, sepsis, or life-threatening complications.

What care should be taken after surgery?

Immediately after surgery:

  • Avoid coughing, constipation, or heavy lifting
  • Report any redness, discharge, or pain at the wound site to your doctor immediately

Long-term care:

Mesh fully integrates into your body in 6–8 months. So, after surgery patients are advised to

  • Avoid lifting heavy weights during this period
  • Treat cough and constipation promptly to avoid excessive pressure on the abdomen
  • Maintain a healthy weight and start gentle exercises like walking to prevent recurrence
  • Regular exercise like walking helps lose extra fat and prevent recurrence.

Frequently Asked Questions (FAQs)

1. What percentage of people develop an incisional hernia after surgery?

Immediately after surgery:

  • Avoid coughing, constipation, or heavy lifting
  • Report any redness, discharge, or pain at the wound site to your doctor immediately

Long-term care:

Mesh fully integrates into your body in 6–8 months. So, after surgery patients are advised to

  • Avoid lifting heavy weights during this period
  • Treat cough and constipation promptly to avoid excessive pressure on the abdomen
  • Maintain a healthy weight and start gentle exercises like walking to prevent recurrence
  • Regular exercise like walking helps lose extra fat and prevent recurrence.
2. How long after surgery can it appear?

It can develop months or even years after the original surgery.

3. What happens if it’s left untreated?

Untreated hernias can become irreducible or strangulated, cutting off blood flow to intestines — a life-threatening condition that requires emergency surgery.

4. Is it a major surgery?

No, mesh repair is a routine procedure and not life-threatening in most cases.

5. How long is the recovery time?
  • Laparoscopic repair: Discharge the next day; normal activity from day 2–3; desk jobs can resume in 3 days.
  • Open repair: Recovery may take longer; strenuous activity should be avoided for 6–12 months.
How can I lower my risk of incisional hernia?
  • Allow your body to heal before returning to strenuous activity.
  • Follow your surgeon’s advice regarding lifting and exercise.
  • Manage chronic cough, constipation, and diabetes effectively.
  • Maintain a healthy weight and balanced diet to support healing.
At The Best Gastro Care Center

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Our expert team provides world-class treatment for Incisional Hernias and other gastrointestinal diseases using advanced techniques and compassionate care.

📞 Book your appointment today to consult our specialist gastro for timely diagnosis and treatment.