When to Seek Urgent Care
Seek emergency care for sudden severe pain, a firm swelling that will not reduce, vomiting, abdominal distension, fever, skin colour change or inability to pass stool or gas. These may indicate obstruction or trapped bowel.
Understanding the Condition
An incisional hernia may appear months or years after an abdominal operation as a swelling beneath or beside the scar. It can enlarge and cause pain, difficulty with activity, bowel symptoms or loss of abdominal-wall strength.
Previous wound infection, obesity, diabetes, smoking, emergency surgery and repeated operations increase risk. There may be more than one defect, muscle separation or mesh from an earlier repair.
How It Is Assessed
The surgeon examines the scars, skin, defect size, muscle function and whether the hernia reduces. CT of the abdomen and pelvis is commonly used for a moderate, large, recurrent or complex hernia. The actual images show the muscles, bowel, old mesh and tissue planes needed for planning.
Blood count, nutrition, diabetes, smoking, weight, breathing and heart health are reviewed. Previous operation notes and mesh records are particularly useful.
When Is Surgery Considered?
Repair is considered when the hernia causes pain, enlarges, affects daily activity, threatens the skin or causes episodes of obstruction. A small reducible hernia with little impact may be observed with emergency advice.
Before planned reconstruction, smoking cessation, diabetes control, treatment of anaemia, nutritional correction and a realistic weight plan can reduce wound problems. Urgent symptoms still need prompt assessment.
Surgery and Important Risks
Most incisional hernias need mesh reinforcement. The surgeon aims to close the deep abdominal-wall gap and place broad mesh in a secure tissue plane, often behind the muscles. Larger defects may require release of deeper muscle layers so the midline can close without excessive tension. Surgery may be open, laparoscopic, robotic or combined.
Risks include bleeding, fluid collection, wound breakdown, infection, bowel injury, fistula, breathing problems, blood clots, chronic discomfort and recurrence. The best approach depends on the defect, previous mesh, adhesions, skin quality and your overall health.
Recovery and Follow-up
Length of stay ranges from day-care for a small repair to several days after reconstruction. Walking, breathing exercises, clot prevention and pain control begin early. Drains or an abdominal binder may be used for specific reasons.
Activity increases gradually while the repair heals. Seek review for fever, persistent vomiting, breathlessness, increasing wound pain, redness, discharge or a rapidly enlarging swelling.