Ventral Hernia

    Weakness in the abdominal wall can cause the internal organs to push out, forming a bulge. This condition is called a hernia.

    A ventral hernia is a condition wherein the abdominal wall bulges out due to weakness in the muscles of the abdomen, causing pain and other complications. A ventral hernia most commonly occurs at the midline, but can also be found on any other area of the abdomen.

    Ventral hernias can be of different types depending on the location of the bulge.

    • Umbilical hernia: A bulge surrounding the belly button or navel
    • Incisional hernia: A bulge around or directly along a prior abdominal surgical incision
    • Epigastric hernia: A bulge above the navel

    Ventral Hernia

    A ventral hernia may develop at any stage of life. Sometimes, they form in infants, during or after pregnancy, or following a surgery. Ventral hernias are most commonly seen in patients who have undergone open abdominal surgeries like appendectomy. The risk of developing a ventral hernia increases if a patient is obese, has a history of hernias, has injuries to the bowel region, begins heavy work relatively early after a surgery, has persistent coughing or develops an infection at the site of a surgical incision.

    What are the Signs & Symptoms?

    The most common symptom of a ventral hernia is sharp pain in the abdominal region that worsens with physical activities such as lifting heavy objects, coughing, or during difficult bowel movements.

    Sometimes, the abdominal contents or intestines loop into the bulge and become trapped in the weakened muscle layer. If this occurs, the blood supply can be cut off, which may lead to death of the trapped tissue. This is called strangulation and requires immediate medical attention. Vomiting, constipation and discoloration of the bulge are common signs of strangulation.

    Other symptoms of a ventral hernia include bulging of the abdominal wall accompanied by tenderness in the affected area, difficulty in standing up, pain while coughing and straining during bowel movements.

    What are the methods of Screening & Diagnosis?

    Your doctor will conduct a medical history and physical examination of your abdomen. Your hernia pouch will be examined when you lie down and stand. Your doctor may try to push the bulge back inside your abdomen, and will ask you to cough to see if there is any change in the size of the bulge.

    Your doctor may also order the following tests:

    • Blood tests: complete blood count test (red blood and white blood cell count) to check for infections
    • Ultrasound of the abdomen: This is a non-invasive procedure that uses high frequency sound waves to capture images of organs in the abdomen. Sound waves emitted from the transducer are reflected back and converted to pictures on a video screen. The ultrasound will help your doctor determine the part of the abdomen protruding into the bulge.
    • CT scan of the abdomen: A CT scan uses a computer that gets data from several X-ray images of organs inside the abdomen and converts them into images displayed on a monitor. With the help of a CT scan, your doctor will be able to ascertain the presence of a hernia, its size and cause.

    What are the Treatment Options?

    Ventral hernias may cause serious complications if left untreated. Treatment is decided based on the clinical condition of your hernia, general health of the patient and if it is a recurrent hernia. The commonly adopted surgical procedures are described below:

    • Ventral Hernia Repair Mesh

      Open surgery: In this procedure, a large incision is made in the abdomen. The protruding tissue or organ is pushed back to its original position and sewed securely. A specially designed synthetic or biologic mesh patch is then sewed over the weakened area in the abdominal wall once the hernia is pushed back to reinforce the abdominal wall, thereby reducing the risk of hernia recurrence.

    • Laparoscopic Ventral Hernia Repair

      Keyhole or laparoscopic surgery: In this procedure, the surgeon makes a few small incisions on your abdomen to insert the laparoscope (a slender viewing tube with an attached camera) and other surgical instruments. Carbon dioxide gas will be introduced to help your surgeon view the surgical site more clearly. Images captured by the laparoscope on a video monitor guide your surgeon through the surgery. Your surgeon separates the hernia sac from the surrounding tissues. The other surgical instruments inserted along with the laparoscope are used to push the organs back into their original position. A special mesh is secured by sutures, staples or tacks behind the abdominal muscles, so as to reinforce the abdominal wall and minimize the risk of hernia recurrence.