Incisional hernia repair

An incisional hernia occurs when abdominal contents push through a weakness in the abdominal wall at the site of a previous surgical incision. It may present as a swelling or bulge under or near an old scar and may become more noticeable with coughing, standing, or straining.

Symptoms may include discomfort, pain, swelling, bowel obstruction, or cosmetic concerns. Surgery is usually recommended to prevent enlargement or complications such as incarceration or strangulation of bowel.

What to expect

Before Your Surgery

  • Authorization should be obtained prior to surgery and will be done by the hospital or the rooms staff depending on whether you are an in- or outpatient.
  • Make sure that you have been fasting for solid foods for at least 6 hours prior to your surgery and for clear liquids or water for at least 2 hours prior to your surgery. Discuss your chronic medications with your doctor or hospital staff prior to your surgery as you usually are allowed to take chronic medications the day of surgery, barring diabetic medication the day of the procedure. If you are taking any blood thinning medication please discuss these in detail with your doctor as special arrangements need to be made for these.
  • Weight optimisation, smoking cessation, and good diabetic control may be advised before surgery to reduce complications and recurrence.

Day of Surgery

You will be admitted to hospital and taken to theatre. After surgery, you will be monitored in recovery before transfer to the ward. You may have intravenous fluids, wound drains, dressings, or a urinary catheter depending on the procedure performed.

Procedure

The procedure is performed under general anaesthesia. The previous scar is usually reopened, and the hernia contents are returned into the abdominal cavity.

The abdominal wall defect is then repaired using sutures and commonly reinforced with a surgical mesh to strengthen the abdominal wall and reduce recurrence risk.

The procedure may be performed:

  • As an open repair, or
  • Using a laparoscopic (keyhole) approach, depending on the size and complexity of the hernia.

Drains may be inserted if required.

Procedure Length

The procedure usually takes 1–3 hours, depending on the size and complexity of the hernia repair.

Possible Complications

  • Possible complications include bleeding, infection, seroma formation, chronic pain, mesh infection, bowel injury, recurrence of the hernia, poor wound healing, bowel obstruction, and unintended damage to surrounding structures.

Duration of Hospital Stay

Hospital stay is usually 1–3 days, depending on the size of the hernia repair, pain control, mobility, and recovery.

Discharge Instructions

  • Keep the wound clean and dry. Take prescribed pain medication and antibiotics if provided.
  • Avoid constipation and straining. Support the abdomen when coughing or moving. An abdominal binder may be recommended after surgery.
  • Please contact the rooms if you develop fever, worsening pain, increasing swelling, vomiting, wound redness, discharge, or recurrence of a bulge.

Return to Activities

  • Light walking is encouraged. Avoid heavy lifting, abdominal strain, gym activity, and strenuous exercise for at least 6 weeks after surgery.

Back to Work Estimation

  • Desk work: approximately 2–3 weeks.
    Physically demanding work: approximately 6–8 weeks, depending on recovery and the size of the repair.

Follow-Up and Results Discussion

A follow-up appointment may be arranged 5–7 days after surgery for wound review and drain removal if necessary.

A further follow-up is usually arranged 10–14 days after surgery for wound assessment, suture or clip removal if required, and review of recovery progress. Histology discussion will occur if tissue was sent for analysis.