HERNIA / ABDOMINAL WALL · CONDITION GUIDE
Incisional Hernia
A hernia through a previous abdominal surgical scar — repaired laparoscopically or open with mesh reinforcement to prevent recurrence.
ABOUT THIS CONDITION
What is Incisional Hernia?
An incisional hernia is a protrusion of abdominal contents through a weakness or defect at the site of a previous surgical incision. It develops in 10–15% of abdominal operations, particularly following midline laparotomy, and is predisposed by wound infection, obesity, malnutrition, and chronic cough. It presents as a visible or palpable bulge at the scar site, which may cause pain, increase in size, or develop complications such as obstruction or strangulation. Dr. Tagore Mohan Grandhi performs laparoscopic and open incisional hernia repair with mesh at Lux Hospitals, Hyderabad. Mesh reinforcement significantly reduces recurrence compared to suture repair alone. The laparoscopic approach is preferred for most incisional hernias, while component separation is reserved for large complex abdominal wall defects where primary fascial closure would be under unacceptable tension.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Previous abdominal surgery — present in all incisional hernias
- Wound infection increasing fascial breakdown and scar weakness
- Obesity increasing intra-abdominal pressure on the repair
- Malnutrition impairing collagen formation and wound healing
- Chronic cough, COPD, or chronic straining
- Use of corticosteroids or immunosuppressants impairing healing
CLINICAL DETAILS
KeyFacts
10–15% of abdominal operations develop incisional hernia
Mesh reinforcement preferred — reduces recurrence to 5–10%
Preferred approach for most hernias
Component separation for giant or recurrent defects
Return to normal activity in 4–6 weeks
Available at Lux Hospitals, Hitech City, Hyderabad
HOW WE TREAT IT
Treatment Approach
Laparoscopic Mesh Repair
Laparoscopic incisional hernia repair places a large mesh through small keyhole incisions to cover the fascial defect from within the abdomen. Dr. Grandhi uses intraperitoneal onlay mesh (IPOM) technique, achieving durable repair with reduced recurrence, less post-operative pain, and earlier return to activity compared to open repair.
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Assessment & Hernia Characterisation
Clinical examination defines the defect size, reducibility, and skin changes. CT abdomen assesses the hernia sac contents, fascial defect dimensions, and abdominal wall anatomy to plan the repair.
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Pre-operative Optimisation
Weight loss is recommended before repair of large hernias. Smoking cessation, nutritional optimisation, and management of comorbidities reduce complication risk.
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Laparoscopic or Open Mesh Repair
Laparoscopic IPOM: mesh is placed intraperitoneally to cover the defect with wide overlap. Open repair: suture closure of the fascial defect with mesh overlay or underlay. Component separation for large defects facilitates primary fascial closure.
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Recovery & Hernia Prevention
Abdominal binder support for 4–6 weeks. Return to light activity in 1–2 weeks; strenuous activity at 6 weeks. Weight management and avoidance of straining prevent recurrence.
AVAILABLE TREATMENTS
TreatmentOptions
Laparoscopic Hernia Repair
Keyhole intraperitoneal mesh placement covering the fascial defect. Preferred approach for most incisional hernias with lower recurrence and faster recovery.
Hernia Repair (Open)
Open fascial closure with mesh overlay or underlay reinforcement for incisional hernias not suitable for laparoscopic approach.
Component Separation for Giant Hernias
Surgical release of the abdominal wall musculoaponeurotic layers to achieve tension-free midline closure for large complex defects, combined with mesh reinforcement.
COMMON QUESTIONS
Frequently Asked Questions
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