Incisional hernia repair: the better bets

What happens when you get weak spots in muscle walls that are normally tight?
A hernia occurs when an organ or a fatty tissue protrudes through a weak muscle or surrounding connective tissue(fascia).


1. Inguinal hernia (abdominal fat or a loop of small intestine invading the inguinal canal).
* Men (mostly over the age of 40) are affected because of the natural weakness in the groin area.
2. Incisional hernia
* Occurs because of an unhealed previous incision.
3. Femoral hernia (outer groin)
   * These are rare but more frequently seen in women.
4. Umbilical hernia
* This type of a hernia is noticed at the time of one's birth and are seen as protrusions at the navel.
* This condition is seen in babies as a birth defect, middle-aged mums and also in the elderly.
5. Hiatal hernia (upper stomach)
6. Epigastric hernia (formed between the belly button (umbilicus) and sternum.)
*These hernias are often painless and require surgery when they become painful.

Risk factors - Incisional hernia

➔ Obesity
➔ Pregnancy
➔ Diarrhea & chronic constipation
➔ Bowel movements
➔ Lifting heavy loads
➔ Excess pressure from coughing, sneezing
➔ Overexertion that can force internal organs to bulge through


A hernia hardly heals by itself and usually grows larger, therefore, it's important to diagnose it at the right time.
* Ultrasound examination: In the initial stages more so in obese people.
* CT scan may be required in some patients to confirm the contents of hernial sac and the size of the defect.

Ways out:

In Order to determine the best type of treatment regarding an incisional hernia, your general surgeon may take to monitoring your condition at first. The type of repair differs according to the location and nature of a hernia. No technique is considered the best solution for hernia treatment. The knowledge of a wide variety of techniques, however, may prove beneficial. The agenda behind the surgical approach is to push the bulging tissue/organ back in place, remove any scar tissue, and adhere a surgical mesh to prevent recurrence.

Laparoscopy is a minimally invasive procedure in which a fiber instrument called a laparoscope inserted through a small incision about ½ - 1 inch long. The laparoscope is aided with cameras (at the tip) that projects real-time images onto the screen. Your abdomen is normally inflated with harmless gas this allows surgeons to peek into the abdomen without major incisions. Reduced blood loss and less scaring while operating under a general anesthetic are made possible with a keyhole surgery. These “keyholes” also act as portals for the medical instruments that a surgeon will use to cover a hernia with a small piece of mesh.

In an Open surgery, the lower part of your body is numbed with local or spinal anesthesia. The surgeon opens your skin by a small incision. After pushing the hernia back into place the weak spot (of the muscles) is sealed with stitches. At times the surgeon may add a piece of flexible mesh for extra support.

The chances of a hernia (incisional) to make a come back is very less. The rate of recurrence is about 5-20 percent in patients who have undergone a hernia repair. Incisional hernias < 10 cm in diameter can be treated with a laparoscopic approach, Laparoscopic hernia repair. Hernias > 10 cm are best repaired by open surgery.

*No need to panic, a hernia can happen to anyone.

At Dr. R.K. Sinha’s (Mumbai) expert surgeons are highly trained at all facets of incisional hernia repair.