Incisional hernias occur when a hole develops at an old incision site in the abdominal wall, that allows fat or bowel to push through, appearing as a lump under the skin. As scar tissue is not as strong as normal tissue, abdominal wall incisions are common sites for hernias to develop.

Repair of incisional hernias requires returning the contents of the hernia (bowel or fat) to the abdominal cavity. The hole in the abdominal wall is repaired with sutures where possible and a mesh is used to cover the repaired defect. This mesh is important as it provides reinforcement to the repair reducing the chance of the repair failing. Sometimes more complex repair techniques are required to deal with very large hernias.

Depending on the size of the hernia and your abdominal contour, the hernia may be best repaired by either a laparoscopic or an open approach. The best approach for your hernia will be discussed with you at your consultation.

Serious complications of incisional hernia repair are uncommon. Complications include:

• Bleeding
• Wound infection and breakdown
• Persistent pain
• Bowel injury
• Mesh infection
• Adhesions of bowel to mesh leading to bowel erosion or obstruction

All hernias can recur even with a good repair and if you do all the right things after surgery. The risk of recurrence can be reduced by:

• Losing weight if you are overweight
• Avoiding very heavy lifting
• Avoiding straining with bowel or bladder movements (treating constipation and symptomatic prostate enlargement)

The length of stay required in hospital after incisional hernia repair varies but is typically 1-2 days. For larger complex hernias a longer stay may be required. Recovery is variable depending of the complexity of the hernia repair and this will be discussed with you at your consultation. Even if you are feeling great it is important to follow your postoperative instructions, particularly limits to lifting, as the repair needs time to develop strength.