Dr Pinkesh Dubai

Ventral Hernia: Causes, Symptoms & Surgical Management

Dr Pinkesh Dubai

INTRODUCTION

Ventral hernias are a common condition that occurs when an opening or weakness occurs in the abdominal wall. This opening can be caused by fat pushing through or weakened tissue allowing it to bulge out.

Ventral hernias are often found in overweight people, but not all ventral hernias are caused by obesity. They can also occur after previous abdominal surgery or abdominal trauma, especially if internal stitches become loose over time and allow the contents from inside to get pushed through the wall of muscle that usually holds everything together.

A ventral hernia is a protrusion or bulge through the abdominal wall

A ventral hernia is a protrusion or bulge through the abdominal wall. It occurs when an internal organ pushes out through weak tissue or a part of your intestine pushes out beyond your belly button.

There are two types of ventral hernias:

  • A Median hernia happens when tissues of your abdomen are weak and allow organs to push through them, causing a bulge in your skin. This type of hernia can happen anywhere around the belly button (the umbilical area).
  • A Para-Median hernia happens away from the midline, on either side, when fat or internal organs push into surrounding muscles and cause them to stretch out. This type of hernia can occur anywhere in the upper abdomen and sometimes even further up toward the chest area (the thoracic region) or down in the lower abdomen ( the supra pubic region).

The Common Causes of Ventral Hernia:

The most common cause of a ventral hernia is obesity.

Obesity is the most common cause of a ventral hernia, and it can be a risk factor for this condition. Obesity places excessive pressure on the abdominal wall, which may lead to a protrusion from underneath the skin.

 

Other factors that may increase the risk of a ventral hernia include:

  • Strenuous physical activity,
  • Pregnancy, and
  • Certain medical conditions such as inflammatory bowel disease, diabetes, and chronic obstructive pulmonary disease (COPD).
  • Poor muscle tone, which can lead to weakness in the abdominal wall.
  • Certain chronic diseases such as diabetes and cirrhosis.
  • Aging, which makes the body less elastic.

 

Ventral hernias can also occur after previous abdominal surgery.

A ventral hernia can also occur after previous abdominal surgery. This is also a very common cause of ventral hernias. The risk of developing a ventral hernia after surgery is higher if you have had previous abdominal surgery or if your abdomen has been weakened by obesity, smoking, or other factors.

After the previous abdominal surgery, the healing process can sometimes be impaired or delayed due to certain conditions, leading to a weakened area and a weak scar line. This can then develop into a Ventral Hernia.

These ventral hernias are also called Incisional Hernias since they happen after surgery and at the site of the previous Incision.

How to Diagnose a Ventral Hernia?

There are several ways to diagnose a ventral hernia.

  • Ultrasound
  • CT Scan
  • MRI

 

The most common is a CT scan, which takes serial x-rays of the abdomen. Because it can see through skin and tissue, the CT scan accurately diagnoses an abdominal hernia.

 

An MRI may also be an alternative to this method because it can give more detailed images than a CT scan, but it's not as precise when looking for soft tissue problems like abdominal hernias.

 

Ultrasound imaging of the abdominal wall is valuable in managing patients with unclear diagnoses for abdominal wall hernias. It can reduce costs by expediting treatment and providing more efficient care to patients.

Ultrasound imaging is also a safe and non-invasive tool that can be used in your doctor’s office without radiation or contrast material, making it especially useful for patients with medical conditions that prevent them from undergoing other diagnostic tests.

How to Treat a Ventral Hernia?

The standard procedure for repairing this type of hernia involves an open surgical approach, with the placement of a mesh to reinforce the repair.

The standard procedure for repairing this type of hernia involves an open surgical approach, with the placement of a mesh to reinforce the repair. This is performed using an incision in the abdominal wall and often requires general anesthesia. The mesh is placed in the abdominal wall and covers the hernia defect to prevent it from returning.

Laparoscopic Surgery for Ventral Hernia:

Laparoscopy, or Minimally invasive surgery, is rapidly becoming the Gold Standard in Ventral Hernia Repair.

  • Minimally invasive surgery, using small incisions and laparoscopic instruments, is used in selected patients.
  • The minimal invasive repair is also reinforced with a Mesh.
  • The Mesh used in Laparoscopic Surgery is of a particular type and usually larger than the one used in open surgery
  • The advantage is that a larger area can be covered with tiny incisions.
  • Laparoscopic Surgery is usually conducted as a Day Care Surgery, and you can go home the same day.
  • The laparoscopic surgery is done under general anesthesia and lasts about 1-1.5 hrs.
  • You will be able to go home the same day but may need some painkillers for a few days after surgery.
  • You will also have to take antibiotics for 10-14 days, depending on your surgeon, and follow up with them as per their instructions.
  • The most significant advantage of Laparoscopic Surgery is that it results in a faster recovery time, less pain, and a smaller scar.

Complications following Surgery for Ventral Hernia:

The most common complication following ventral hernia surgery is a recurrence.

The second most common complication associated with ventral hernia repair is infection. This can present as fever or tenderness around the site of surgery within hours after surgery or even several days later.

Patients with a history of chronic illness (including diabetes), smoking, or immunosuppression may be at higher risk of developing an infection following ventral hernia repair.

Other complications include:

  • wound dehiscence (when part of your wound breaks down)
  • seroma (an accumulation of fluid under your skin).

Why You Need Expert Care?

The most common complication following ventral hernia surgery is a recurrence, so it is essential to seek treatment from an experienced surgeon.

Because recurrence is so common, it is essential to seek treatment from an experienced surgeon.

Re-operation is often successful at preventing or treating a ventral hernia if performed early enough. However, re-operation may be required even years after the initial surgery, although this is less common than a recurrence after the first year.

In some cases, the surgeon may choose a different approach for your second operation if you have had previous scarring or other complications due to infections or adhesions that make your case more complex than usual.

Consult With Your Surgeon

If you think you have a ventral hernia, please seek care.

See your doctor if you experience any of the symptoms listed above, as they can lead to further complications if not treated properly.

If you have a family history of hernias or other conditions predisposing you to have one, talk with your doctor about that and about how best to prevent one from developing.

If your doctor diagnoses a ventral hernia, ask them what treatment options are available so that the two of you can make an informed decision on what course of action would be most appropriate for your situation.

CONCLUSION

As you can see, there are many different types of hernias. They all have different causes and symptoms, but they all share one thing in common: they need treatment.

If you suspect you have or have had a hernia, please seek care from an experienced surgeon!

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