Abdominal wall hernias are a group of abnormalities, which result from weaknesses and loss of support in the abdominal wall. This can lead to free movement of abdominal contents through the abdominal wall defect and to the space just below the skin. Often times, these can be seen as bulges, which can be painful or uncomfortable during sitting or during the lifting of heavy objects. Abdominal wall hernias can be present within the umbilicus, referred to as umbilical hernias, or above or below the umbilicus, known as ventral hernias. They can also be found in the inguinal areas in each groin as a result of defects, which may be congenital in nature or due to pressure from daily activities. Inguinal hernias can be categorized as direct or indirect types.. Incisional hernias are rare and may result from previous surgeries, such as cesarean sections. They can also be diagnosed at the time of initial consultation.
Patients with abdominal hernias often complain of fullness, swelling, intermittent pain or discomfort. If the hernia becomes incarcerated, meaning a portion of abdominal content such as a loop of a small intestine becomes caught within the hernia and does not return back into to abdominal cavity, this can be an urgent cause of need for surgery to repair the hernia. In the most extreme cases, an incarcerated hernia can result in bowel obstruction, which is a surgical emergency to prevent bowel necrosis and acute abdomen. Therefore, with the presence of any form of abdominal hernia, it is important to discuss a repair of the hernia, especially if the hernia is symptomatic and is clinically large enough to permit incarceration.
How are Hernias repaired?
Abdominal wall hernias can be repaired directly or they can be repaired with the use of synthetic mesh by your plastic surgeon. In some situations, the use of the synthetic mesh is required to decrease the chance of hernia reoccurrence or failure of the repair. Patients who wish to undergo corrective abdominal surgery, such as abdominoplasty (tummy tuck), may also present with an abdominal wall hernia or incisional hernia that can be corrected at the same time. In some cases, a CT scan or computer tomography of the abdominal wall is required to access the degree and extent of the defect and possible need for synthetic mesh.