Everything You Need to Know About Incisional Hernias

The most noticeable symptom of an incisional hernia is a bulge near the incision site. It’s often most visible when you strain your muscles, such as when you stand up, lift something, or cough.

Besides a visible bulge, incisional hernias might also cause:

• nausea and vomiting
• fever
• burning or aching near the hernia
• abdominal pain and discomfort, particularly around the hernia
• faster heartbeat than usual
• constipation
• diarrhea
• thin, narrow stool

While you’re most likely to develop a hernia between three and six months after your surgery, hernias can occur before or after this time frame.

Reducible vs. irreducible

Hernias are often categorized as reducible or irreducible:

• Reducible hernias can be pushed back in. They may also shrink when you lie down.
• Irreducible hernias happen when part of your intestine pushes into the hernia, making it hard to push the hernia back in.

Irreducible hernias can lead to bowel obstruction, which can then lead to a strangulated hernia. This requires immediate treatment.

Call your healthcare provider right away if you notice that the bulge has tuned dark red or purple or you feel severe pain.

Incisional hernias happen when the surgical cut in your abdominal wall doesn’t close properly after surgery. This can cause your abdominal muscles to weaken, allowing tissue and organs to form a hernia.

Several things can prevent the surgical cut from healing properly, including:

• putting too much pressure on your abdomen
• becoming pregnant before the cut fully heals
• getting back into physical activities too soon after surgery

Sometimes, there’s no clear reason why a surgical cut doesn’t properly heal.

Hernias are more likely after emergency surgery or surgery that requires a large incision. If the edges of the wound aren’t properly aligned after surgery, the incision may not heal well, increasing the likelihood of a hernia. The sewing technique used to close the incision can also play a part.

Several risk factors can increase the chances of a hernia developing after surgery, including:

• wound infection
• existing health conditions, such as renal failure, diabetes, or lung disease
• obesity
• smoking
• certain medications, including immunosuppressant drugs or steroids

You can help lower your risk for a hernia by taking the recommended amount of time to heal after abdominal surgery.

Hernias can still develop in the absence of any other risk factors, so it’s important to follow medical guidelines for recovery after any procedure. Even if you feel fully recovered, avoid exercise or other strenuous activity until your healthcare provider clears you.

Hernias don’t go away on their own and are only treatable with surgery.

Small or reducible hernias

If you have a small or reducible hernia, you may be able to safely delay surgery. Your healthcare provider will consider your medical history and other factors when deciding if surgery will repair the hernia.

If your hernia causes little or no discomfort, it may be safe to watch the hernia and wait before having surgery. It’s important to note, though, that operations for larger hernias can be more difficult than operations for small hernias.

If you do forego surgery, your healthcare provider may fit you for a special belt that helps to keep pressure on the hernia, preventing it from sticking out.

Large or irreducible hernias

If your hernia grows or becomes irreducible, you’ll need surgery. The recommended option will generally depend on your symptoms, the size of the hernia, and your medical history.

Open repair

Open hernia repair involves an incision at the hernia site. A surgeon will move tissue, intestine, and other organs forming the hernia back into the abdomen and close the opening.

They may also use mesh patches to reinforce the spot where the hernia developed. These mesh patches are sewn to the tissue around the hernia, where they’ll eventually be absorbed by your abdominal wall.

Laparoscopic repair

Laparoscopic hernia repair involves multiple small cuts instead of one large cut. Hollow tubes are placed in these incisions, and air inflates your abdomen to make your organs more visible. A surgeon will then insert surgical tools, including a small camera, into the tubes to perform the surgery. Mesh may also be used in a laparoscopic repair.

Laparoscopic surgery is less invasive, and you may leave the hospital sooner and have a lower risk of infection, though it might not be as effective for very large or severe hernias.

The most serious complications of incisional hernias are bowel obstruction and strangulation. A strangulated hernia can cause tissue death in your intestine. This condition may be life-threatening if you don’t get treatment right away. It’s also possible for hernias to rupture, but this is extremely rare.

Small hernias that go untreated tend to get larger over time. If a hernia gets too big, it can cause swelling and pain in your abdomen and eventually become irreducible. You’ll likely notice quickly if this happens because it tends to cause a lot of discomfort.

If a hernia of any size causes significant pain or discomfort or has a negative effect on your quality of life, contact your healthcare provider right away. Complications can be potentially life-threatening, so it’s best to have any unusual symptoms looked at just in case.

Incisional hernias aren’t necessarily a cause for concern, but you’ll want to have it looked at by your healthcare provider. In some cases, you might be able to just keep an eye on the area. In others, you may need surgical repair to avoid future complications.

With the use of mesh patches, many people make a full recovery from hernias and don’t go on to develop recurring hernias.