What is a ventral hernia?
A ventral hernia is any hernia on the front of the abdominal wall. These usually occur around the umbilicus (umbilical hernia, paraumbilical hernia) or in the midline of the abdomen (epigastric hernia). Occasionally ventral hernias occur in other locations on the abdominal wall.
What is a hernia?
A hernia is a bulge or protusion of the contents of the abdomen (eg intestines) through a weakness in the muscle of the abdominal wall leading to a bulge or lump.
How does a hernia occur?
Hernias can occur as a result of a weakness in the muscle wall from birth or through gradual weakening of the muscles.
What symptoms do ventral hernias cause.
Ventral hernias can cause a variety of symptoms from mild discomfort to a bulge, swelling or lump in the abdominal wall. Ventral hernias can sometimes cause complications and acute pain as a result of bowel within the hernia becoming trapped, and occasionally the bowel may loose its blood supply and this piece of bowel may need to be removed at emergency surgery.
What does the operation involve?
Ventral hernias can be repaired either by an open operation or using laparoscopic (keyhole) surgery techniques. Both are performed under general anaesthetic.
Small ventral hernias are best repaired with an open technique. A small incision is made under the hernia and it is gently pushed back into the abdomen. The defect in the wall is then either sutured or reinforced with synthetic mesh. The procedure usually takes about 30 minutes
Larger ventral hernias or those that have recurred following a previous open repair or within a scar from previous abdominal surgery may be repaired using laparoscopic techniques. Under a general anaesthetic a small port is put into the abdomen through which a telescope will be inserted and gas (carbon dioxide) is pumped to distend the abdomen. Further small tubes are inserted through which the surgeon puts the instruments.
The surgeon will reduce the hernia contents into the abdomen and a piece of synthetic mesh is tacked to the abdominal wall to reinforce the wall. The ports will be removed and the wounds closed with glue.
What are the options?
Surgery is the only reliable way to treat ventral hernias. We know that without treatment hernias will gradually get bigger over time. Hernias also have a risk of causing complications that require emergency surgery and a larger operation.
What are the benefits of surgery?
The aim of surgery is that the hernia should be repaired and that you should be free of pain and able to return to normal activity and exercise. You will also be free of the risk of complications.
What are the risks?
Ventral hernia repair, both open and laparoscopic, is a safe and frequently performed procedure. Significant complications are rare but include injury to the bowel, bleeding and a small risk of infection of the mesh if it is used. Occasionally in open surgery the wound may become infected and require antibiotics.
The chance of the hernia recurring after surgery is approximately 5%. This may require a further operation
Most patients can have a small ventral hernia repaired as a day case procedure although occasionally people may prefer to stay one night. Larger hernias and laparoscopic hernia repairs usually require 1-2 nights stay in hospital.
Depending on the size of the hernia you will be able to return to work within 1-2 weeks and gradual return to full activity with 2-4 weeks.
An ventral hernia is a common problem and both open and laparoscopic ventral hernia repairs are safe and frequently performed procedures that should allow you to return to work quickly, allow you to be free from pain and the risk of hernia complications.
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