Abdominal hernias are a very common diagnosis, especially following previous surgery. A hernia is defined as contents moving from one cavity into another cavity. In the case of abdominal hernias, abdominal contents such as bowel, colon, and fat are pushed out of the abdominal cavity. Weaknesses in the strength layer of the abdominal wall, called fascia, are the locations of the herniation. This can happen at the esophageal hiatus called a hiatal hernia. See section on Hiatal hernias. Ventral abdominal hernias are when the abdominal contents are pushed out through the ventral abdominal wall. This happens through the weakest spot on the abdominal wall. Examples of these spots include a prior abdominal incision from a surgery or a weak spot in the fascia.
bowel herniating into a defect in the ventral abdominal wall Hernia defects from a laparoscopic view Small Bowel
Hernias only progress over time and do not get better on their own. The feared complication from a ventral abdominal hernia is that parts of the gastrointestinal tract, such as bowel, get trapped in a hernia and lose blood supply. This portion of the bowel dies and can cause infection, sepsis, and possibly death. This situation requires an emergent operation, and possibly several subsequent surgeries.
Ventral hernias are common especially following prior open abdominal surgeries such as laparotomy for a bowel resection, hysterectomy, or cesarean section. Most commonly found without prior surgery is an umbilical hernia from the failure of the umbilicus (aka belly button) to close early in life. There are also hypotheses that patients can have weak fascia from their genetic makeup predisposing them to develop hernias. These hernias are exacerbated by obesity causing the progression to larger hernias faster and are more difficult to repair.
Hernias do not get better on their own.
Surgical repair is the only method to fix a hernia.
Repair of ventral abdominal hernias can be accomplished several ways and largely depends on the type of a hernia and its size. Your surgeon will decide the best method for your hernia.
Studies show that use of mesh provides a more sturdy repair creating dense scar tissue that decreases recurrence. This practice uses mesh as a standard method to repair in most hernias.
Repairing the ventral abdominal hernia with a piece of mesh
Postoperative recovery may involve admission to the hospital. This depends on the size and repair of an abdominal hernia. Six weeks following the repair should refrain from lifting anything greater than 15 pounds and avoiding strenuous activity. This allows the mesh to integrate, proper scar tissue to be created, and the maximal strength achieved following repair.