Knowledge

Incisional hernia

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this manner, the weakened tissue of the original hernia is never re-incised to perform the repair, and one can minimize the potential for wound complications such as infections. In addition, performance of the operation through smaller incisions can make the operation less painful and speed recovery. Laparoscopic repair has been demonstrated to be safe and a more resilient repair than open incisional hernia repair.
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incision required to perform this surgery. A mesh infection after this type of hernia repair most frequently requires a complete removal of the mesh and ultimately results in surgical failure. In addition, large incisions required for open repair are commonly associated with significant postoperative pain. Reported recurrence rates after open repair are up to 20% and influenced by mesh size and fixation type.
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Traditional "open" repair of incisional hernias can be quite difficult and complicated. The weakened tissue of the abdominal wall is re-incised and a repair is reinforced using a prosthetic mesh. Complications, particularly infection of the incision, frequently occur because of the large size of the
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Laparoscopic incisional hernia repair is a new method of surgery for this condition. The operation is performed using surgical microscopes and specialized instruments. The surgical mesh is placed into the abdomen underneath the abdominal muscles through small incisions to the side of the hernia. In
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Regeneration by autologous tissue stem cells is a unique method for repair of large incisional hernias. It not only obviates causative factors responsible for herniation but utilises these factors to strengthen repair and regeneration of traumatised tissues.
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Clinically, incisional hernias present as a bulge or protrusion at or near the area of a surgical incision. Virtually any prior abdominal operation can develop an incisional hernia at the scar area (provided adequate
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Sharma, A.; Dey, A.; Baijal, M.; Chowbey, P.K. (2011). "Laparoscopic repair of suprapubic hernias: transabdominal partial extraperitoneal (TAPE) technique".
124:, or infection, all of which result in decreased wound healing. They may also be caused by increased intra-abdominal pressure due to a chronic cough (as in 712: 265:
Edwards, C.; Geiger, T.; Bartow, K.; et al. (2009). "Laparoscopic transperitoneal repair of flank hernias: A retrospective review of 27 patients".
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technique under tension. For this reason, it is especially advised that these be repaired via a tension free repair method using a synthetic
92:. While incisional hernias can occur at any incision, they tend to occur more commonly along a straight line from the xiphoid process of the 624:
Gurusamy, Kurinchi Selvan; Allen, Victoria B (2013-12-17), The Cochrane Collaboration (ed.), "Wound drains after incisional hernia repair",
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due to their location. Not all ventral hernias are from incisions, as some may be caused by other trauma or congenital problems.
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Nguyen, S.Q.; Divino, C.M.; Buch, K.E.; Schnur, J.; Weber, K.J.; Katz, L.; Reiner, M.A.; Aldoroty, R.A.; Herron, D.M. (2008).
1078: 990: 730: 100:, and are more complex in these regions. Hernias in these areas have a high rate of recurrence if repaired via a simple 1291: 698: 1963: 1810: 445:"Regeneration of Abdominal Wall Aponeurosis: New Dimension in Marlex Peritoneal Sandwich Repair of Incisional Hernia" 1708: 164:
It is uncertain whether wound drains insertion after incisional hernia repair is associated with better outcomes.
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Schumpelick, V.; Klinge, U.; Junge, K.; Stumpf, M. (2004). "Incisional abdominal hernia: the open mesh repair".
1703: 1659: 1553: 1375: 974: 542:"Postoperative pain after laparoscopic ventral hernia repair: A prospective comparison of sutures versus tacks" 1914: 1760: 1669: 1188: 796: 133: 883: 1249: 1178: 779: 1522: 1478: 1431: 1237: 855: 1868: 1548: 1183: 1141: 954: 829: 816: 786: 757: 673: 116:
Incisional hernias are usually caused by a weakness of the surgical wounds, which may be caused by
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Bingener, J.; Buck, L.; Richards, M.; Michalek, J.; Schwesinger, W.; Sirinek, K. (2007).
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The technique is now published in R. Maingot's textbook of abdominal operations in 1997.
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does not occur due to infection), including large abdominal procedures such as
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caused by an incompletely-healed surgical wound. Since median incisions in the
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LeBlanc, K.A. (2005). "Incisional hernia repair: Laparoscopic techniques".
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Matapurkar, B.G.; Bhargave, A.; Dawson, L.; Sonal, B. (1999).
1286: 1016: 442: 353:"Biomechanical abdominal wall model applied to hernia repair" 498: 307: 125: 720: 59:, ventral incisional hernias are often also classified as 351:
Lyons, M.; Mohan, H.; Winter, D.C.; Simms, C.K. (2015).
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Park, E.; Roth, J.S. (2006). "Abdominal wall hernia".
350: 144:. They can also result from poor surgical technique. 655: 264: 1992: 215: 546:Journal of Society of Laparoendoscopic Surgery 706: 623: 216:Bucknall, T.E.; Cox, P.J.; Ellis, H. (1982). 812:Esophagogastric junction outflow obstruction 851:Esophageal intramural pseudodiverticulosis 713: 699: 557: 516: 368: 241: 180: 626:Cochrane Database of Systematic Reviews 580: 1993: 1835: 1079:Small intestinal bacterial overgrowth 694: 66: 13: 14: 2012: 1964:Spontaneous bacterial peritonitis 1811:Exocrine pancreatic insufficiency 651: 1709:Secondary sclerosing cholangitis 950:Gastric antral vascular ectasia 945:Portal hypertensive gastropathy 822:Gastroesophageal reflux disease 617: 574: 533: 84:, and small incisions, such as 1704:Primary sclerosing cholangitis 1554:Hepatic veno-occlusive disease 1376:Solitary rectal ulcer syndrome 634:10.1002/14651858.cd005570.pub4 492: 483: 436: 393: 344: 301: 258: 209: 174: 1: 1761:Sphincter of Oddi dysfunction 167: 132:, urinary obstruction (as in 90:abdominal exploratory surgery 57:abdominal exploratory surgery 1670:Postcholecystectomy syndrome 1189:Intestinal pseudoobstruction 797:Esophageal motility disorder 195:10.1067/j.cpsurg.2006.02.004 147: 7: 10: 2017: 1655:Gallstone / Cholelithiasis 1179:Functional colonic disease 975:Zollinger–Ellison syndrome 518:10.1001/archsurg.142.6.562 1949: 1828: 1769: 1683: 1640: 1486: 1477: 1430: 1384: 1339: 1225: 1112: 1002: 989: 864: 856:Acute esophageal necrosis 738: 729: 659: 595:10.1007/s00268-005-7971-1 414:10.1007/s00464-010-1513-0 322:10.1007/s00423-003-0352-z 279:10.1007/s00464-009-0477-4 29: 24: 955:Gastric dumping syndrome 830:Laryngopharyngeal reflux 817:Diffuse esophageal spasm 583:World Journal of Surgery 449:World Journal of Surgery 234:10.1136/bmj.284.6320.931 111: 1571:Alcoholic liver disease 1104:Bile acid malabsorption 1048:Peptic (duodenal) ulcer 1581:Hepatic encephalopathy 965:Buried bumper syndrome 896:Peptic (gastric) ulcer 780:Mallory–Weiss syndrome 723:human digestive system 1806:Pancreatic pseudocyst 1675:Porcelain gallbladder 787:Zenker's diverticulum 310:Langenbecks Arch Surg 96:straight down to the 1610:Hepatorenal syndrome 1549:Budd–Chiari syndrome 1506:Autoimmune hepatitis 1331:Intestinal adhesions 1089:Short bowel syndrome 918:Functional dyspepsia 836:Esophageal stricture 802:Nutcracker esophagus 1749:Choledocholithiasis 1620:Metabolic disorders 1586:Acute liver failure 1559:Portal hypertension 1511:Alcoholic hepatitis 1354:Radiation proctitis 1273:Mesenteric ischemia 1245:Gastroenterocolitis 1074:Blind loop syndrome 884:MĂ©nĂ©trier's disease 792:Barrett's esophagus 1924:Undefined location 1915:Grynfeltt–Lesshaft 1816:Pancreatic fistula 1799:Pancreatic abscess 1754:Biliary dyskinesia 1725:Mirizzi's syndrome 1226:Large and/or small 906:Dieulafoy's lesion 775:Boerhaave syndrome 461:10.1007/PL00012326 67:Signs and symptoms 16:Surgical condition 1988: 1987: 1984: 1983: 1824: 1823: 1426: 1425: 1283:Bowel obstruction 985: 984: 688: 687: 273:(12): 2692–2696. 228:(6320): 931–933. 55:are frequent for 45:incisional hernia 41: 40: 25:Incisional hernia 19:Medical condition 2008: 1976:Pneumoperitoneum 1833: 1832: 1743:Common bile duct 1625:Wilson's disease 1615:Peliosis hepatis 1484: 1483: 1361:Proctalgia fugax 1268:Abdominal angina 1193:Ogilvie syndrome 1142:Pseudomembranous 1000: 999: 960:Gastric volvulus 925:Pyloric stenosis 736: 735: 721:Diseases of the 715: 708: 701: 692: 691: 657: 656: 645: 644: 621: 615: 614: 589:(8): 1073–1079. 578: 572: 571: 561: 537: 531: 530: 520: 496: 490: 487: 481: 480: 440: 434: 433: 408:(7): 2147–2152. 397: 391: 390: 372: 370:10.1002/bjs.9687 348: 342: 341: 305: 299: 298: 262: 256: 255: 245: 213: 207: 206: 178: 86:appendix removal 82:vascular surgery 22: 21: 2016: 2015: 2011: 2010: 2009: 2007: 2006: 2005: 1991: 1990: 1989: 1980: 1945: 1934:Internal hernia 1820: 1765: 1730:Biliary fistula 1688: 1679: 1665:Adenomyomatosis 1660:Cholesterolosis 1636: 1630:Hemochromatosis 1501:Viral hepatitis 1473: 1422: 1380: 1366:Rectal prolapse 1335: 1302:Fecal impaction 1292:Intussusception 1255:Crohn's disease 1221: 1204:Toxic megacolon 1116: 1114:Large intestine 1108: 1053:Curling's ulcer 1006: 1004:Small intestine 993: 981: 889:Gastroenteritis 860: 725: 719: 689: 684: 683: 668: 654: 649: 648: 622: 618: 579: 575: 538: 534: 497: 493: 488: 484: 441: 437: 398: 394: 363:(2): e133-139. 349: 345: 306: 302: 263: 259: 214: 210: 183:Curr Probl Surg 179: 175: 170: 150: 114: 69: 61:ventral hernias 36:General surgery 20: 17: 12: 11: 5: 2014: 2004: 2003: 1986: 1985: 1982: 1981: 1979: 1978: 1973: 1971:Hemoperitoneum 1968: 1967: 1966: 1955: 1953: 1947: 1946: 1944: 1943: 1942: 1941: 1936: 1931: 1920: 1919: 1918: 1917: 1912: 1899: 1898: 1893: 1888: 1883: 1878: 1877: 1876: 1871: 1860: 1859: 1854: 1853: 1852: 1841: 1839: 1830: 1826: 1825: 1822: 1821: 1819: 1818: 1813: 1808: 1803: 1802: 1801: 1796: 1791: 1786: 1775: 1773: 1767: 1766: 1764: 1763: 1758: 1757: 1756: 1751: 1738: 1737: 1732: 1727: 1718: 1717: 1716: 1711: 1706: 1695: 1693: 1681: 1680: 1678: 1677: 1672: 1667: 1662: 1657: 1652: 1646: 1644: 1638: 1637: 1635: 1634: 1633: 1632: 1627: 1617: 1612: 1607: 1606: 1605: 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962: 957: 952: 947: 942: 937: 932: 927: 922: 921: 920: 910: 909: 908: 903: 893: 892: 891: 886: 881: 870: 868: 862: 861: 859: 858: 853: 848: 843: 838: 833: 827: 826: 825: 819: 814: 809: 804: 794: 789: 784: 783: 782: 777: 767: 766: 765: 760: 755: 744: 742: 733: 731:Upper GI tract 727: 726: 718: 717: 710: 703: 695: 686: 685: 682: 681: 669: 664: 663: 661: 660:Classification 653: 652:External links 650: 647: 646: 616: 573: 552:(2): 113–116. 532: 511:(6): 562–567. 491: 482: 455:(5): 446–451. 435: 392: 343: 300: 257: 208: 189:(5): 326–375. 172: 171: 169: 166: 149: 146: 113: 110: 68: 65: 39: 38: 33: 27: 26: 18: 15: 9: 6: 4: 3: 2: 2013: 2002: 1999: 1998: 1996: 1977: 1974: 1972: 1969: 1965: 1962: 1961: 1960: 1957: 1956: 1954: 1952: 1948: 1940: 1937: 1935: 1932: 1930: 1927: 1926: 1925: 1922: 1921: 1916: 1913: 1911: 1908: 1907: 1906: 1905: 1901: 1900: 1897: 1894: 1892: 1889: 1887: 1884: 1882: 1879: 1875: 1872: 1870: 1867: 1866: 1865: 1862: 1861: 1858: 1855: 1851: 1848: 1847: 1846: 1845:Diaphragmatic 1843: 1842: 1840: 1838: 1834: 1831: 1827: 1817: 1814: 1812: 1809: 1807: 1804: 1800: 1797: 1795: 1792: 1790: 1787: 1785: 1782: 1781: 1780: 1777: 1776: 1774: 1772: 1768: 1762: 1759: 1755: 1752: 1750: 1747: 1746: 1745: 1744: 1740: 1739: 1736: 1733: 1731: 1728: 1726: 1722: 1719: 1715: 1712: 1710: 1707: 1705: 1702: 1701: 1700: 1697: 1696: 1694: 1692: 1686: 1682: 1676: 1673: 1671: 1668: 1666: 1663: 1661: 1658: 1656: 1653: 1651: 1650:Cholecystitis 1648: 1647: 1645: 1643: 1639: 1631: 1628: 1626: 1623: 1622: 1621: 1618: 1616: 1613: 1611: 1608: 1604: 1601: 1599: 1596: 1595: 1594: 1593:Liver abscess 1591: 1587: 1584: 1582: 1579: 1578: 1577: 1576:Liver failure 1574: 1572: 1569: 1565: 1562: 1560: 1557: 1555: 1552: 1550: 1547: 1546: 1545: 1544: 1540: 1536: 1533: 1532: 1531: 1528: 1524: 1521: 1520: 1519: 1516: 1512: 1509: 1507: 1504: 1502: 1499: 1498: 1497: 1494: 1493: 1491: 1489: 1485: 1482: 1480: 1476: 1468: 1465: 1464: 1463: 1460: 1456: 1453: 1451: 1448: 1447: 1446: 1443: 1441: 1438: 1437: 1435: 1433: 1429: 1419: 1416: 1414: 1411: 1409: 1406: 1404: 1401: 1399: 1395: 1392: 1391: 1389: 1387: 1383: 1377: 1374: 1372: 1369: 1367: 1364: 1362: 1359: 1355: 1352: 1351: 1350: 1347: 1346: 1344: 1342: 1338: 1332: 1329: 1325: 1322: 1321: 1320: 1317: 1313: 1310: 1309: 1308: 1305: 1303: 1300: 1298: 1295: 1293: 1290: 1288: 1284: 1281: 1279: 1276: 1274: 1271: 1269: 1265: 1264: 1260: 1256: 1253: 1252: 1251: 1248: 1246: 1243: 1239: 1236: 1235: 1234: 1233:Enterocolitis 1231: 1230: 1228: 1224: 1218: 1214: 1210: 1207: 1205: 1201: 1198: 1194: 1190: 1187: 1185: 1182: 1181: 1180: 1177: 1175: 1172: 1168: 1165: 1163: 1160: 1158: 1155: 1153: 1150: 1148: 1145: 1143: 1140: 1139: 1138: 1135: 1133: 1130: 1129: 1127: 1124: 1120: 1115: 1111: 1105: 1102: 1100: 1097: 1095: 1092: 1090: 1087: 1085: 1082: 1080: 1077: 1075: 1072: 1070: 1067: 1065: 1061: 1060:Malabsorption 1058: 1054: 1051: 1050: 1049: 1046: 1042: 1039: 1037: 1034: 1032: 1029: 1028: 1027: 1024: 1023: 1021: 1018: 1014: 1010: 1005: 1001: 998: 996: 992: 988: 976: 973: 972: 971: 968: 966: 963: 961: 958: 956: 953: 951: 948: 946: 943: 941: 938: 936: 935:Gastroparesis 933: 931: 928: 926: 923: 919: 916: 915: 914: 911: 907: 904: 902: 901:Cushing ulcer 899: 898: 897: 894: 890: 887: 885: 882: 880: 877: 876: 875: 872: 871: 869: 867: 863: 857: 854: 852: 849: 847: 846:Megaesophagus 844: 842: 839: 837: 834: 831: 828: 823: 820: 818: 815: 813: 810: 808: 805: 803: 800: 799: 798: 795: 793: 790: 788: 785: 781: 778: 776: 773: 772: 771: 768: 764: 761: 759: 756: 754: 751: 750: 749: 746: 745: 743: 741: 737: 734: 732: 728: 724: 716: 711: 709: 704: 702: 697: 696: 693: 680: 676: 675: 671: 670: 667: 662: 658: 643: 639: 635: 631: 627: 620: 612: 608: 604: 600: 596: 592: 588: 584: 577: 569: 565: 560: 555: 551: 547: 543: 536: 528: 524: 519: 514: 510: 506: 502: 495: 486: 478: 474: 470: 466: 462: 458: 454: 450: 446: 439: 431: 427: 423: 419: 415: 411: 407: 403: 396: 388: 384: 380: 376: 371: 366: 362: 358: 354: 347: 339: 335: 331: 327: 323: 319: 315: 311: 304: 296: 292: 288: 284: 280: 276: 272: 268: 261: 253: 249: 244: 239: 235: 231: 227: 223: 219: 212: 204: 200: 196: 192: 188: 184: 177: 173: 165: 162: 158: 154: 145: 143: 139: 135: 131: 127: 123: 119: 109: 107: 103: 99: 95: 91: 87: 83: 79: 75: 64: 62: 58: 54: 50: 47:is a type of 46: 37: 34: 32: 28: 23: 1928: 1923: 1902: 1779:Pancreatitis 1741: 1691:biliary tree 1564:Nutmeg liver 1541: 1467:Hematochezia 1418:Pruritus ani 1403:Anal abscess 1398:Anal fistula 1394:Anal fissure 1307:Constipation 1261: 1132:Appendicitis 940:Gastroptosis 930:Achlorhydria 769: 758:Eosinophilic 672: 625: 619: 586: 582: 576: 549: 545: 535: 508: 504: 494: 485: 452: 448: 438: 405: 401: 395: 360: 356: 346: 313: 309: 303: 270: 266: 260: 225: 221: 211: 186: 182: 176: 163: 159: 155: 151: 130:constipation 115: 70: 60: 44: 42: 1959:Peritonitis 1721:Cholestasis 1699:Cholangitis 1642:Gallbladder 1530:Fatty liver 1450:Hematemesis 1432:GI bleeding 1238:Necrotizing 1167:Lymphocytic 1162:Collagenous 1157:Microscopic 1094:Steatorrhea 995:Enteropathy 841:Inlet patch 763:Herpetiform 748:Esophagitis 402:Surg Endosc 267:Surg Endosc 1951:Peritoneal 1929:Incisional 1850:Congenital 1794:Hereditary 1771:Pancreatic 1735:Haemobilia 1408:Hemorrhoid 1386:Anal canal 1324:Infectious 1312:Functional 1147:Ulcerative 1031:Duodenitis 970:Gastrinoma 679:D000069290 316:(1): 1–5. 168:References 78:intestinal 1939:Richter's 1896:Spigelian 1891:Obturator 1881:Umbilical 1714:Ascending 1685:Bile duct 1518:Cirrhosis 1496:Hepatitis 1479:Accessory 1349:Proctitis 1200:Megacolon 1174:Dysentery 1084:Whipple's 1036:Jejunitis 1026:Enteritis 913:Dyspepsia 874:Gastritis 807:Achalasia 740:Esophagus 611:189870909 505:Arch Surg 387:205514994 357:Br J Surg 148:Treatment 138:pregnancy 31:Specialty 1995:Category 1869:Indirect 1864:Inguinal 1598:Pyogenic 1543:Vascular 1319:Diarrhea 1297:Volvulus 1263:Vascular 1202: / 1191: / 1152:Ischemic 1119:Appendix 1009:Duodenum 879:Atrophic 753:Candidal 642:24346957 603:15983711 568:18435881 527:17576893 477:22198415 469:10085391 430:25506589 422:21184109 379:25627126 338:20775829 330:14745557 295:22252827 287:19462203 222:Br Med J 203:16679124 118:hematoma 2001:Hernias 1910:Petit's 1886:Femoral 1789:Chronic 1603:Amoebic 1371:Anismus 1137:Colitis 1064:Coeliac 1041:Ileitis 1013:Jejunum 866:Stomach 770:Rupture 559:3016187 252:6279229 243:1496540 142:ascites 94:sternum 74:healing 53:abdomen 1904:Lumbar 1874:Direct 1857:Hiatus 1837:Hernia 1689:Other 1455:Melena 1341:Rectum 824:(GERD) 640:  609:  601:  566:  556:  525:  475:  467:  428:  420:  385:  377:  336:  328:  293:  285:  250:  240:  201:  122:seroma 102:suture 49:hernia 1829:Other 1784:Acute 1535:MASLD 1488:Liver 1462:Lower 1445:Upper 1287:Ileus 1123:Colon 1017:Ileum 832:(LPR) 607:S2CID 473:S2CID 426:S2CID 383:S2CID 334:S2CID 291:S2CID 140:, or 112:Cause 98:pubis 1217:SCAD 674:MeSH 638:PMID 599:PMID 564:PMID 523:PMID 465:PMID 418:PMID 375:PMID 326:PMID 283:PMID 248:PMID 199:PMID 126:COPD 106:mesh 1523:PBC 1250:IBD 1184:IBS 630:doi 591:doi 554:PMC 513:doi 509:142 457:doi 410:doi 365:doi 361:102 318:doi 314:389 275:doi 238:PMC 230:doi 226:284 191:doi 136:), 134:BPH 128:), 88:or 80:or 43:An 1997:: 1687:/ 1285:: 1266:: 1062:: 677:: 636:, 605:. 597:. 587:29 585:. 562:. 550:12 548:. 544:. 521:. 507:. 503:. 471:. 463:. 453:23 451:. 447:. 424:. 416:. 406:25 404:. 381:. 373:. 359:. 355:. 332:. 324:. 312:. 289:. 281:. 271:23 269:. 246:. 236:. 224:. 220:. 197:. 187:43 185:. 120:, 108:. 1723:/ 1396:/ 1215:/ 1211:/ 1125:) 1121:/ 1117:( 1019:) 1015:/ 1011:/ 1007:( 714:e 707:t 700:v 666:D 632:: 613:. 593:: 570:. 529:. 515:: 479:. 459:: 432:. 412:: 389:. 367:: 340:. 320:: 297:. 277:: 254:. 232:: 205:. 193::

Index

Specialty
General surgery
hernia
abdomen
abdominal exploratory surgery
healing
intestinal
vascular surgery
appendix removal
abdominal exploratory surgery
sternum
pubis
suture
mesh
hematoma
seroma
COPD
constipation
BPH
pregnancy
ascites
doi
10.1067/j.cpsurg.2006.02.004
PMID
16679124
"Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies"
doi
10.1136/bmj.284.6320.931
PMC
1496540

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