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. It is often seen in the midline between the umbilicus and the xiphoid process. Other terminologies used to describe this hernia include epigastric hernia and supraumbilical hernia, describing the anatomic locations of these ventral hernias. Factors resulting in ventral hernias 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. They are among 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 and laparoscopic methods.
Due to high potential for recurrence if hernias are repaired with sutures alone, ventral and incisional 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 after 4-6 weeks.