If the wound does not heal properly after abdominal surgery, a weakness (or incisional hernia) results.
This happens after 1 in 4 operations.
Risk factors for developing an incisional hernia include emergency surgery, wound infection, obesity, smoking, chronic cough, closure technique, diabetes and connective tissue disorders.
These surgical (or incisional) hernias are uncomfortable and may continue to enlarge.
Wearing a hernia belt may provide temporary relief, but over 80% of people end up with an operation to repair the hernia.
5% of incisional hernias undergo emergency repair due to blockage (obstruction) or strangulation of the bowel.
If a large abdominal lump appears when lifting your head off the pillow, it is typically a divarication of the recti muscles (moving apart of muscles).
Because there is no hole in the abdominal wall, this is not a hernia. It does not cause complications such as obstruction or strangulation.
Divarication is typically repaired for cosmetic reasons by plastic surgeons and is not routinely repaired by general surgeons. It may need to be repaired if divarication and ventral hernia are present together.
Often (if tissue is weakened or defect large) mesh is used to strengthen the repair and lower the risk of hernia recurrence. Because the structure of he abdominal wall is complex, mesh (dashed blue line) can be placed in a number of planes.
A drain is sometimes placed to limit how much fluid forms around the mesh.
Most patients spend between 1 and 3 nights in hospital and recover over the subsequent 6 weeks.
Depending on type of hernia, 1 in 3 can recur.
