INCISIONAL HERNIA

GENERAL

An incisional hernia is a hernia which develops at the site of a previous operation. This occurs because for some reason the tissues have not healed to their original strength. The weakened tissue now bulges. With this kind of hernia intestines inside the hernia do not often become strangulated.


SIGNS AND SYMPTOMS

• There is a bulge in the area of a previous incision. It may be small or very large.
  
• The hernia may ache especially with coughing.
  

TREATMENT

• These hernias can be treated conservatively with a girdle or similar garment.
  
• Many patients wish to have a hernia repaired because they consider it unsightly or uncomfortable.
  
• Your doctor has decided to do a surgical repair.
  PRE-OPERATIVE
  
• Make sure your doctor is aware of medicines you take, especially medicines which may affect blood clotting.
  
• Your doctor may advise you first of all to deal with factors which jeopardise proper healing after repair. Obesity, prostate trouble, chronic coughing or constipation are the most important.
  

OPERATION

Most of these operations are done under general anaesthetic. There are several different techniques for repairing incisional hernias. Your doctor will advise you how he proposes to repair your hernia and whether he intends using a synthetic mesh.


POST-OPERATIVE

You will be taken to a recovery room and observed there until you are stable. You will then be transferred to your normal hospital bed. Any pain you may have will be controlled with oral or intra-muscular medicines.


HOME-CARE

• You may walk about as you wish but don't overdo things.
  
• Don't initially do anything strenuous.
  
• You may eat as you wish. Include plenty of roughage and liquids in your diet to prevent constipation
  
• Your doctor will discuss with you when you may commence bathing or showering.
  
• Your doctor will discuss with you when you may return to driving and to work.
  

COMPLICATIONS

• Complications occasionally occur after this operation and you must be aware of this.
  
• A bleed or haematoma at the site of the repair is always possible. Should this happen your doctor will decide whether you need to be taken back to the operating theatre.
  
• An infection at the site of the repair is always possible. If this happens it may necessitate surgical treatment or antibiotics.
  
• As with any hernia repair, there is a small incidence of recurrence of the hernia after surgical treatment. There are many different reasons why this may occur. A recurrent hernia may even be larger than the original hernia.
  
• As with any major operation, deep venous thrombosis and pulmonary embolism is always possible.