Overview
An incisional hernia develops at the site of a previous abdominal surgical incision, occurring when the abdominal wall fails to heal completely, leaving a weakness through which abdominal contents can protrude. Incisional hernias are one of the most common long-term complications of abdominal surgery, with an incidence of 10 to 15% following laparotomy. Risk factors for incisional hernia development include wound infection, obesity, malnutrition, diabetes, chronic cough, immunosuppression, and the use of certain surgical techniques. They range in size from small, asymptomatic defects to large, complex hernias containing significant amounts of bowel which carry a higher risk of complications.
The Procedure
At ILS Hospitals, incisional hernia repair is planned based on the size and complexity of the defect. Small defects may be amenable to laparoscopic repair, while large or complex hernias typically require open mesh repair with component separation techniques to reconstruct the abdominal wall. Mesh reinforcement is essential in incisional hernia repair to reduce the risk of recurrence, which remains a significant challenge in large hernias. The mesh is placed in the retrorectus, preperitoneal, or intraperitoneal position depending on the surgical approach. Component separation, the release of abdominal wall fascial layers may be required to achieve a tension-free closure over large defects.
Recovery
Recovery from incisional hernia repair varies based on the size and complexity of the repair. Large open repairs may require 4 to 8 weeks for full recovery, while laparoscopic repairs offer faster return to activity. An abdominal binder is recommended for several weeks post-operatively. Addressing underlying risk factors, particularly weight management and glycaemic control is crucial to minimise recurrence. At ILS Hospitals, our hernia specialists provide comprehensive pre-operative optimisation, technically precise surgery, and structured long-term follow-up, ensuring durable abdominal wall reconstruction for every patient, regardless of the complexity of their hernia.
