HERNIA / ABDOMINAL WALL · CONDITION GUIDE

Other Ventral Hernia

Q: What is an epigastric hernia?

An epigastric hernia is a protrusion through the linea alba — the midline fibrous band connecting the paired rectus muscles — between the umbilicus and xiphoid process. It usually contains extraperitoneal fat rather than bowel. Epigastric hernias are more common in men and typically present as a small, tender midline bulge.

Q: Can a parastomal hernia be repaired without moving the stoma?

Many parastomal hernias can be repaired laparoscopically by placing a keyhole mesh around the stoma without relocating it. Severe or recurrent parastomal hernias may require stoma relocation to a different site combined with mesh repair of the old stoma site.

Q: What is component separation and when is it needed?

Component separation is a technique that releases the abdominal wall musculoaponeurotic layers — specifically by dividing the external oblique aponeurosis lateral to the rectus muscle — allowing the anterior abdominal wall to be advanced to the midline without tension. It is used for large complex ventral hernias where the fascial edges cannot be approximated without excessive tension.

Protrusions through defects in the anterior abdominal wall — including epigastric, spigelian, and parastomal hernias — repaired with mesh to restore abdominal wall integrity.

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Ventral Hernia Mesh Repair by Dr. Tagore

Various Sites ABDOMINAL WALL

60–90 Min PROCEDURE DURATION

Day Case – 2 Days HOSPITAL STAY

ABOUT THIS CONDITION

What is Other Ventral Hernia?

Ventral hernias encompass all anterior abdominal wall hernias other than inguinal, femoral, and umbilical types. These include epigastric hernias (through the linea alba between the umbilicus and xiphoid), spigelian hernias (through the spigelian fascia lateral to the rectus muscle), parastomal hernias (adjacent to a stoma), and lumbar hernias. They present as abdominal wall bulges, often with associated pain or discomfort. Dr. Tagore Mohan Grandhi repairs ventral hernias at Lux Hospitals, Hyderabad, using laparoscopic mesh repair for most cases. Large or recurrent ventral hernias with significant fascial defects are repaired with open mesh reinforcement or component separation to achieve tension-free midline closure.

SIGNS TO WATCH

Common Symptoms

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Symptoms that need attention

Abdominal wall bulge at or away from the midline Pain or discomfort at the hernia site, worsening with exertion or straining Nausea or discomfort if a bowel loop is within the hernia sac Skin changes over longstanding large hernias Irreducible bulge in incarcerated ventral hernia Difficulty with stoma management in parastomal hernia

WHY IT HAPPENS

Causes & Risk Factors

Congenital weakness in the linea alba or spigelian fascia
Previous abdominal surgery creating fascial weaknesses
Stoma formation causing parastomal hernia over time
Obesity and raised intra-abdominal pressure
Chronic straining from constipation or urinary outflow obstruction
Collagen disorders reducing abdominal wall tensile strength

CLINICAL DETAILS

KeyFacts

Types

Epigastric, spigelian, parastomal, and lumbar hernias

Repair

Mesh reinforcement — laparoscopic or open

Complex Defects

Component separation for large or recurrent hernias

Parastomal

Keyhole mesh repair around stoma to prevent recurrence

Recovery

Day case to 2 days depending on size and approach

Hospital

Available at Lux Hospitals, Hitech City, Hyderabad

HOW WE TREAT IT

Treatment Approach

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Laparoscopic Mesh Repair

Laparoscopic ventral hernia repair places mesh intraperitoneally through small keyhole incisions, covering the fascial defect with wide overlap and avoiding a large abdominal incision. Dr. Grandhi uses laparoscopic repair for most ventral hernias, achieving durable repair with minimal morbidity and same-day or next-day discharge.

Available at Lux Hospitals, Hitech City, Hyderabad

1

Assessment & Hernia Mapping

Clinical examination identifies the hernia type and location. CT abdomen maps the fascial defect, hernia sac contents, and adjacent anatomy to plan the repair and determine appropriate mesh size and approach.
2

Repair Planning

Laparoscopic repair is planned for most ventral hernias. Component separation is planned for large defects requiring primary fascial closure. Parastomal hernias may require stoma relocation.
3

Laparoscopic or Open Mesh Repair

Mesh is placed intraperitoneally or in the preperitoneal space through small incisions to cover the defect with wide overlap. Component separation is performed for large defects to release the abdominal wall and achieve tension-free closure.
4

Recovery

Abdominal binder worn for 4–6 weeks. Light activity resumes within days; heavy lifting avoided for 6 weeks. Long-term weight management and avoidance of straining reduce recurrence risk.

AVAILABLE TREATMENTS

TreatmentOptions

Laparoscopic Hernia Repair

Keyhole intraperitoneal mesh placement for epigastric, spigelian, or other ventral hernias with rapid recovery and durable repair.

Hernia Repair (Open)

Open fascial repair with mesh reinforcement for ventral hernias not suitable for laparoscopic approach.

Component Separation for Giant Hernias

Bilateral release of the abdominal wall layers to achieve tension-free midline fascial closure for large complex ventral defects, combined with mesh reinforcement.

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COMMON QUESTIONS

Frequently Asked Questions

What is an epigastric hernia?+

Can a parastomal hernia be repaired without moving the stoma?+

What is component separation and when is it needed?+

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