About this disease
What it is about
Scar hernias are common. In around 20 percent of patients with an abdominal surgical scar, a weakness of the connective tissue develops over time. This results in a bulge in the area of the scar, which is caused by abdominal fat or abdominal contents (usually intestines) pressing outward through the gap in the abdominal wall at the scar. Factors that favor an incisional hernia are obesity, smoking, high physical stress, wound infections during primary surgery and a family predisposition.
Types
We distinguish several typical locations of abdominal wall hernias. These are at the navel, directly above the navel, below the sternum or, less frequently, laterally at the transition from the straight to the oblique abdominal muscles.
Symptoms and consequences
In most cases, incisional hernias are painless and only become apparent when the abdominal wall is strained, for example, when standing up from a lying position. The sensation of an unstable abdominal wall may also be felt. Rarely, an incisional hernia is painful. In particular, if parts of the intestine repeatedly slip into such an incisional hernia, there may be increased discomfort.
What we do for you
Examination and diagnosis
Usually, an incisional hernia is a visual diagnosis, and the size of the hernia can be palpated quite easily. Since we want to assess the components of the abdominal wall in relation to the incisional hernia, we perform a computed tomography scan in almost all cases. This can also diagnose abdominal wall hernias that were not noticed in an initial examination.
Treatment
The treatment of incisional hernias is usually surgical. The aim is to anatomically restore all layers of the abdominal wall and close the gap. This is usually accomplished using a soft plastic mesh that is sewn into specific layers of the abdominal wall. Minimally invasive techniques are becoming increasingly important, as patients recover much more quickly in this case.