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Incisional Hernia In A Nutshell
“A hernia occurs when an organ is squeezed through an opening in the muscle or tissue that holds it in place. In some cases, the intestines may protrude through a weakened area in a patient’s abdominal wall.”
– Dr Ganesh
Hernias occur mostly in the abdomen region, but they can also appear in the upper thigh, belly button, and groin areas. While most hernia conditions are not immediately life-threatening, they often require surgery to prevent potentially dangerous complications.
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In some instances, whether it’s in adults or children, hernias can cause life-threatening complications. It is recommended that you seek emergency care if you experience symptoms such as nausea or vomiting, fever, or sudden pain.
Early medical care and changes can minimise symptoms. However, surgery is the only way to treat a hernia effectively. There are different types of surgeries available for hernia repairs, and your surgeon can advise on which one is recommended for you.
While the prognosis for hernia repair surgery is typically very good, it is also dependent on the nature of the hernia, your symptoms and overall health. Occasionally, the hernia may recur following repair.
One of the most common symptoms of a hernia is a bulge or lump in the affected area. For example, in the case of an umbilical hernia, it occurs as a bulge that shows through the weakened spot near the belly button or navel.
One in five babies is born with an umbilical hernia. However, if the hernia does not resolve when the baby reaches four years of age, treatment may be required. You might also experience some pain and discomfort in the area around the lump.
In some types of hernia, such as hiatal hernias, specific symptoms may be observed, such as heartburn, trouble swallowing, and chest pain.
In many cases, hernias have no symptoms, and you may not know you have a hernia unless it shows up during a routine check-up or a medical examination for an unrelated problem.
“It’s important to take note of and recognise the symptoms of a hernia and to see your doctor if you suspect that you have one. An untreated hernia won’t go away by itself. Your doctor can assess your hernia and recommend a suitable treatment for your condition.”
– Dr Ganesh Ramalingam
Another form of hernia, known as an incisional hernia is a type of hernia caused by an incompletely-healed surgical wound. It may frequently occur as a complication of wound healing after surgery. Careful treatment and precautions are crucial to avoid its development.
A case of incisional hernia was reported in 2008, documenting a 55-year-old female who showed up at the medical institute with a massive bulge under her clothes. Further investigation uncovered an incisional hernia that has been present since 19 years ago after she did a removal of a branched stone from her right kidney and had repeated sutures.
Although the size of the hernia was reasonably large (10cm in diameter), the patient decided to decline surgery and preferred conservative management of the hernia with frequent follow up.
An incisional hernia occurs through a previous incision or scar in your abdominal wall. It is relatively common, with between 12 to 15 percent of abdominal operations leading to incisional hernia.
Suppose a surgeon has made the incision to reach an internal organ in your body, such as an appendix or a caesarian section – after the operation. In that case, the surgeon will stitch the layers of your abdominal wall close. In cases where the stitches fail to heal correctly or come apart with time, it may result in an incisional hernia. A partial segment of your organ, muscle, or tissue may protrude through the open and weakened surgical opening and place pressure under your surgical scar. This causes pain, swelling, or fever and is known as an incisional hernia.
While an incisional hernia can develop or get larger a few months or years after surgery, most cases happen within three to six months post-surgery, where your incision is the weakest.
An incisional hernia may be caused by an infection, poor wound care, improper surgical techniques and other factors that interfere with the healing of your surgical wound or a past surgical wound.
You would be at a higher risk if you
One of the most common symptoms of an incisional hernia is a noticeable bulge or swelling near the incision site. This bulge may be most visible when you strain your muscles, such as when you stand up, carry weights or lifting or when you cough.
Other signs and symptoms of an incisional hernia include:
In emergency medical conditions:
During a consultation session, our doctor will be able to diagnose an incisional hernia during a physical examination. Hernia becomes noticeable only when you perform activities that place extra pressure on your abdomen. You may be asked to cough or strain so that our doctor can observe if the hernia bulges out.
Should you need further tests to screen for complications, you may be scheduled for an X-ray, abdominal ultrasound or blood tests.
Based on the state of your hernia, our doctor may be able to assess and categorise the condition into two categories: Reducible or Irreducible.
Irreducible hernias may lead to bowel obstruction, and in some cases to a strangulated hernia. When that happens, it is recommended to seek medical attention immediately.
If you should notice that the bulge has turned dark red or purple or you feel severe pain, the recommended advice is to seek medical attention as well.
It is important to note that incisional hernias do not heal on their own. Depending on the condition of the hernia, they may require surgical treatment to repair.
People who recently went through abdominal surgery are at risk of developing incisional hernias. The risk factor is higher in the initial three to six months following the procedure when the tissues are healing from the incision.
Small hernias that go untreated tend to increase in size over time. If a hernia grows too big, it can cause swelling and pain in your abdomen and eventually become irreducible. The swelling can be noticeable as this happens as it tends to cause much discomfort.
The most severe complications of incisional hernias are bowel obstruction and strangulation. Bowel obstruction occurs when the tissues around your hernia or intestines become blocked by the hernia. This tissue may die if not immediately treated with surgery.
One further complication is if your intestine happens to be strangulated, this leads to a cut off of blood supply to the region, resulting in the death of tissue and formation of gangrene.
If treatment is not carried out promptly, peritonitis, which is infection and inflammation of the abdomen lining and its contents, may occur. Peritonitis is a life-threatening condition which should be avoided.
In the experience shared by Europe PMC, a 60 years old lady presented the medical centre with a ruptured incisional hernia following a bout of cough. She developed an incisional hernia following a tubectomy at the age of 30. The patient was recommended surgery for an incisional hernia in the past but refused to undergo the same.
Due to the seriousness of the condition, surgery was planned, and hernia repair was immediately administered. Thankfully, the operation went through successfully, and the wound healed well without any infection. Three months later, the patient showed no signs of complications during the follow-up.
While spontaneous rupture of an abdominal hernia is an infrequent complication, the rupture of an abdominal hernia is recommended for emergency surgery. This case is presented to emphasise the need for early operative intervention to prevent complications of incisional hernia.
Surgery is the only way to remove the incisional hernia altogether and prevent serious complications which may otherwise occur.
An incision hernia typically does not reduce in size or go away by itself. The hernia would continue to grow larger. Planned surgery is recommended to avoid an emergency as it would involve fewer complications.
If an incision hernia is diagnosed promptly and suitably treated with surgery, the chances of it recurring is only between five to ten per cent. Should the incision hernia get to a stage which requires emergency surgery, surgical complications can be more severe than that of the planned surgery.
When treating an incisional hernia, there are two ways that the repair surgery may be performed. This is either an open hernia repair or laparoscopic hernia repair.
During a conventional open hernia repair, our doctor will make an incision to access the hernia over the bulge site. Doctors will then move tissue, intestine, and other organs forming the hernia back into the abdomen and close the opening.
Mesh patches are used to reinforce and support the area where the hernia developed. These mesh patches are attached to the tissue surrounding the hernia, forming a layer that will be absorbed by your abdominal wall. Applying a mesh would also help reduce the chances of a recurrence of the hernia in the region.
A laparoscopic hernia repair is a less invasive procedure, and our doctor will make several smaller incisions around the hernia bulge site. A long, thin tube with a lighted camera on its end is inserted into one of the incisions, allowing doctors to see inside your abdominal cavity on a video screen.
The goal of either type of procedure is the same. The surgeon would place the bulging intestine or other intra-abdominal tissue and lining back through the hole in the abdominal wall. The hole is then sewed closed. A synthetic mesh material may be inserted into the abdomen to strengthen the area.
Robotic surgery should be considered for an incisional hernia repair when the risks of utilising traditional methods outweigh the benefits.
The greatest advantage of robotic surgery is its precision. Designed with 3D-imaging technology and highly advanced cameras, robotic equipment can guide minimally invasive instruments to exact locations within the patient’s body to reduce potential damage or trauma.
Additionally, incisional hernia repair using a robotic surgical technique allows doctors to access difficult-to-reach areas with greater accuracy, resulting in smaller incisions and a reduced downtime for our patients.
After your surgery, it is normal to experience pain around the surgical site. To aid this, your surgeon will prescribe medication to help ease this discomfort as you recover.
Tending to your wound would require extra care. You are advised to carefully follow your surgeon’s instructions to prevent complications or infections during your recovery.
Open surgery typically requires a longer recovery process when compared to laparoscopic surgery. Your surgeon will let you know when you can return to your normal routine.
Following a hernia repair, you may be unable to move around naturally for several weeks, and you may be advised to avoid strenuous or heavy activity. Additionally, you should avoid carrying and lifting heavy objects during this recovery period. This is to prevent adding stress and strain to the wound.
Due to the nature of a hernia, stay away from heavy lifting. Weightlifting could cause further herniation and deterioration of the condition, so it is advisable not to weight lift whilst you have the hernia.
In an article posted on ACI Health, Tracey documented her experience managing her incision hernia.
Tracey experienced an incisional hernia because a previous operation’s scar line had weakened her stomach. While lifting heavy objects, Stacey noticed her bulge was getting larger.
In this minimally invasive procedure, patients might experience less discomfort and scarring after hernia surgery and can engage in normal activities more quickly. Laparoscopic hernia repair surgery by Dr Ganesh Ramalingam at G & L Surgical Clinic in Singapore is preferred by patients looking for a reduced recovery period. Laparoscopic hernia repair surgery has proven to be highly effective with more than 90 per cent of hernias not returning after the procedure.
Dr Ganesh at G & L Surgical Clinic strives to prioritise his patients’ recovery and comfort. Having had adequate experience in performing advanced laparoscopic hernia surgeries for numerous patients for many years in Singapore.
Furthermore, the staff at G & L Surgical Clinic have been thoroughly and adequately trained to make your experience a comfortable and hassle-free one. Whether you intend to undergo our hernia treatments procedures or other medical services in Singapore, you can rest assured that you will be properly and sufficiently cared for by trained professionals.
Organise a consultation with our surgeons for further assistance on hernia treatments in Singapore.
What Happens If I Don’t Treat My Incisional Hernia?
If left untreated, the hernia can cause complications like bowel obstruction or increase in size and become strangulated. This disrupts your blood supply and will need immediate medical assistance.
Can An Incisional Hernia Get Bigger?
Yes, the hernia can get larger and become strangulated. Surgery may be recommended if your hernia continues to grow over time.
Why Do I Feel Moderate Pain That Intensifies Throughout The Day?
Hernias can cause pain for a variety of reasons. A hernia occurs when an organ or tissue protrudes through a weak spot or hole in the muscle or surrounding tissue that holds it in place. The protrusion of the organ or tissue can put pressure on the surrounding tissue and cause discomfort or pain. The pain may be constant or intermittent and may be worse when you are physically active or when you are standing or sitting for long periods of time. Hernia pain may also be exacerbated by coughing, sneezing, or straining during bowel movements.
Does Exercise Make Incisional Hernia Worse?
Strenuous and high-intensity exercises can cause more pain in your hernia. It’s best to stick to low-impact exercises like walking and swimming.
Will The Pain Eventually Subside If I Stop Strenuous Activities?
It is not uncommon for hernia pain to fluctuate or come and go. However, if the hernia is not treated, the pain is likely to persist and may even worsen over time. Hernias can become larger and more uncomfortable as the protrusion of the organ or tissue puts additional pressure on the surrounding tissue.
Due to my work, I got a hernia on my inner thigh and had to see a doctor to get it treated. I found Dr Ganesh online and I am so glad that he is a very patient and caring doctor.
He understood the challenges I faced and proposed that I do hernia repair as the hernia was getting worse. Within a week, I got the procedure scheduled and he helped me to get the hernia repaired. Now, I am back to work and feeling normal with no pain.
Dr Ganesh also gave me good advice to make sure I don’t trigger the condition again. Thank you to all the nurses at G&L Surgical too. All of you are so nice and always smiling, it gave me a great assurance that I am in good hands.
Dr Ganesh is a kind and caring doctor. I had a hernia after childbirth for quite some time but never thought much of it.
However, I noticed that the hernia started to grow larger and I was feeling discomfort from it. It was getting quite painful and I was worried it’s something serious.
I found Dr Ganesh online and scheduled an appointment with him on the day. He assessed that I have an umbilical hernia and recommended that I undergo a hernia repair. As it turns out, fixing the hernia is not a major surgery and I am now back to work with no more bulges on my belly.
I feel much better thanks to him. Thank you to the G&L Team for doing great work!
I had a hernia near my hip and was recommended to Dr Ganesh through a mutual friend. What surprised me most was that Dr Ganesh was unlike any doctor that I have met. My impression of a specialist is that they will always recommend that I undergo surgery but to my surprise, his advice was the opposite. He did an assessment and advised that I did not require a hernia repair as the hernia is still fairly small at the time.
I followed his advice and managed to avoid triggering the pain for about 2 months. However, as I started getting active at the gym, I noticed the hernia was getting larger again and the same discomfort was returning so I went back to visit Dr Ganesh again.
This time around as the hernia is much larger, I had to opt for the hernia repair. Honestly, it wasn’t too bad since I trusted in his skills. The entire procedure was quick and seamless and within a week, I am already back to work.
My absolute gratitude to Dr Ganesh and his team for displaying professionalism, efficiency and assurance that allowed me to be at ease throughout my entire treatment. Your dedication to your work is definitely a blessing and you are truly an amazing doctor!
I had an incisional hernia on the scar above where I had my appendix removed some years ago. It started to bother me and hurt so I came across Dr Ganesh’s clinic online. He’s a friendly doctor and super patient, and had no issues explaining to my husband and I all those questions that we have gathered from reading online.
Turns out it wasn’t as serious as the horror stories we read online but my hernia would definitely need to be repaired.
His team was very fast and booked me in for the procedure within a week. Everything went smoothly and my husband was very pleased that Dr Ganesh was very reassuring. Right before the surgery, Dr Ganesh noticed that he was very worried and even got the staff to grab a cup of coffee for my husband.
I am so grateful to this team for being so kind and thoughtful. If you are even looking for a doctor that cares, this is where you should go. Thank you G&L Clinic!
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