Ventral hernia repair is a common surgical procedure that corrects a weakness in the abdominal wall. It returns displaced tissues or organs to their proper location and reinforces the area to prevent future protrusion.
Understanding Ventral Hernias
A ventral hernia occurs when internal organs or fatty tissue push through a weak spot in the abdominal wall, creating a visible bulge. These hernias can appear at a previous surgical incision site (incisional hernia) or in naturally weaker areas like above the navel (epigastric) or around the belly button (umbilical). Common contributing factors include prior surgery, obesity, chronic coughing, heavy lifting, and pregnancy.
Symptoms often include a noticeable bulge, pain, or pressure at the site. If left untreated, a ventral hernia can enlarge and become more painful. More severe complications can arise if the tissue becomes trapped (incarceration) or if its blood supply is cut off (strangulation). Strangulation is a medical emergency that can lead to tissue death and requires immediate surgical intervention.
Preparing for Ventral Hernia Repair
Preparation for ventral hernia repair involves several steps to ensure a safe and successful outcome. Patients have pre-operative consultations where the surgeon and anesthesia provider review their medical history, current medications, and pain control options. This evaluation often includes blood tests, urinalysis, or imaging scans.
Specific instructions are provided regarding fasting before surgery. Patients are advised to temporarily stop certain medications or supplements days or weeks before the procedure. It is also important to arrange for someone to drive you home after surgery.
How Ventral Hernia Repair is Performed
Ventral hernia repair is typically performed under general anesthesia, meaning the patient is asleep during the procedure. The goal of the surgery is to return the protruding tissue to the abdominal cavity and reinforce the weakened abdominal wall. Surgeons use two primary approaches: open repair or laparoscopic repair.
Open repair involves a single, larger incision made directly over the hernia site. The surgeon pushes the bulging tissue back into the abdomen and then repairs the weakened muscle by suturing it closed. For added support and to reduce the likelihood of the hernia returning, a surgical mesh is commonly placed over the repaired area. This mesh acts as a scaffold, encouraging new tissue growth to strengthen the abdominal wall.
Laparoscopic repair is a minimally invasive technique that uses several small incisions, typically three to four, through which a thin, lighted tube with a camera (laparoscope) and specialized surgical instruments are inserted. The surgeon views the internal structures on a monitor to guide the repair. Carbon dioxide gas is often used to inflate the abdomen, creating space for the surgeon to work. Similar to open repair, surgical mesh is frequently used to reinforce the abdominal wall in laparoscopic procedures. A variation of the laparoscopic approach is robotic-assisted surgery, where the surgeon controls robotic arms from a console, offering enhanced precision and visualization.
Life After Ventral Hernia Repair
Following ventral hernia repair, patients can expect a recovery period involving managed discomfort and activity restrictions. Immediate post-operative care includes monitoring vital signs in the recovery room and pain management with prescribed medication. Smaller hernia repairs are often outpatient procedures, allowing patients to go home the same day, while larger or more complex repairs may require a hospital stay of one to several days.
Patients may experience mild to moderate pain, swelling, and bruising around the incision sites, along with fatigue. Wound care involves keeping the surgical site clean and dry, and sometimes includes managing a drain to remove excess fluid. Activity is gradually increased, but heavy lifting and strenuous activities are typically restricted for 4 to 6 weeks to allow for proper healing and to reduce the risk of recurrence.
Dietary considerations, including a fiber-rich diet and adequate hydration, are recommended to prevent constipation and strain on the healing area. Follow-up appointments with the surgeon are important to monitor healing progress. Patients should contact their doctor immediately for symptoms like severe pain, fever, significant swelling, or discharge from the incision site, as these may indicate complications.