Ventral or Incisional Hernia Repair

Ventral hernia is a bulge in the anterior abdominal wall. It occurs as a result of a tear in the abdominal wall musculature or fascia. It is often seen in the midline between the umbilicus and the xiphoid process. Other terminologies used to describe this hernia include epigastric hernia, supraumbilical hernia, periumbilical hernia, or spigelian hernia, describing the anatomic locations of these ventral hernias. Factors resulting in a ventral hernia include excess weight, pregnancy, strenuous activities, etc. With time, contents of the abdomen protrude through the hernia as a bulge. This may result in pain, disfigurement, or sometimes incarceration and compromise of bowel.

Incisional hernia is a common type of hernia that occurs at the site a previous surgical incision. When deeper tissues within an incision fail to heal adequately, a defect or hernia is created. Factors resulting in incisional hernias include wound infection, diabetes, long-standing steroid use, excess weight, strenuous activities, etc.

Ventral and incisional hernias are challenging problems that require specialized care. Repair of ventral or incisional hernia is one of the most common procedures performed at our practice. In 2002, Dr. Zaré was the co-principle-investigator of a large multi-institutional randomized controlled trial comparing open versus laparoscopic methods.

Due to high potential for recurrence when ventral hernias are repaired with sutures alone, these hernias are generally repaired with prosthetic mesh. The technique is called ‘tension-free’ repair. With this approach, repair of ventral or incisional hernias are extremely safe and durable. Procedures are usually performed at ambulatory surgery centers. Patients can expect to resume day-to-day activities within a few days, and strenuous activities within 4-6 weeks.