Ventral Hernia

What is a Ventral Hernia?

The protrusion of abdominal contents such as bowel or abdominal fatty tissue through a hole or defect in the abdominal wall muscle layer. This hernia typically is caused by surgery or trauma. Weakness in the abdominal wall can result from heavy lifting, chronic coughing, obesity, or pregnancy. If the protruding loop of intestine or bowel becomes trapped tightly enough to cut of circulation, immediate medical attention is necessary as the condition is very serious. If the hernia occurs where an old surgical scar was then it is called an incisional hernia.

What are the Symptoms of Ventral Hernia?

Lump in abdomen (may be able to be pushed back in (reducible hernia) or may be stuck (irreducible))
Pain in abdomen
Pain and tenderness over lump
Constipation
Abdominal distension

What are the Treatments for Ventral Hernia?

Small asymptomatic ventral hernias can be followed closely reserving repair if they should increase in size or become symptomatic, ie. pain.

Symptomatic or large ventral hernias usually require surgical repair. Surgical repair can either be performed with an incision (open) or laparoscopically. Mesh is usually utilized for hernia repairs, except for smaller defects.

Laparoscopic repair of ventral hernias is performed through multiple small incisions with placement of mesh-securing the mesh to the inner side of the abdominal wall muscle.

The open repair is usually performed through the prior scar. The majority of ventral hernias are repaired using a mesh screen. The mesh is composed of either polypropolene, PTFE (Gortex) or polyester. In addition, biological grafts derived from skin are gaining popularity.

A newer surgical technique which is gaining popularity is the component separation technique. This technique is especially useful for the larger ventral hernias, as well as recurrent ventral hernias.

Postoperative Complications of Ventral Hernia Repair

Ventral hernia repair is often an outpatient procedure that can be performed in the traditional open procedure or using the laparoscopic approach. But just like any other surgery, there is always the risk of postoperative complications.

One major postoperative complication of ventral hernia repair is surgical wound complications. Postoperative wound complications can be minor, resulting in redness and some drainage, and are typically treated on an outpatient basis. Major wound complications are open wounds and wounds that require antibiotic treatment.

Other postoperative complications that can occur are bleeding and injury to the intestines or other abdominal organs. An infection could occur in the mesh, and therefore have to be removed. There is also the risk of the hernia coming back.

LINKS: http://www.covidien.com/hernia/pages.aspx?page=Regionalize

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