Hernia repair
Incisional hernia repair
A hernia through the scar of a previous operation. These repairs are more involved than a first-time hernia, and planning matters more.
In plain language
What this operation is
An incisional hernia appears at the site of an earlier abdominal operation. The scar in the muscle layer is never quite as strong as the original tissue, and over time a gap can open along it.
It shows as a bulge along or beside an old scar, usually more obvious on standing, coughing or straining. It tends to enlarge slowly over months and years.
These repairs are more complex than a first-time hernia. There is scar tissue from the previous surgery, the defect is often irregular in shape, and the abdominal wall around it may be weakened over a wide area. That is why imaging is used more often before deciding the approach.
Who it is for
When this operation is advised
- A bulge along or beside the scar of a previous abdominal operation
- A defect that is enlarging over time
- Discomfort, dragging or difficulty with normal activity
- Skin changes or tenderness over the bulge
And when it is not. Where the defect is very large or the patient has significant other health problems, the timing and the approach need careful planning. Rushing an incisional hernia repair is not in the patient’s interest.
How it works
From assessment to follow-up
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01
Assessment
Examination plus a CT scan in most cases, to map the defect, its contents and the state of the abdominal wall.
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02
Planning
Size, position, previous surgery and general health decide whether keyhole or open repair is appropriate.
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03
The operation
Under general anaesthesia. Adhesions are released, the defect closed, and mesh placed to reinforce a wide area.
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04
Afterwards
A longer period of activity restriction than a simple hernia, with follow-up to check the repair.
Afterwards
What recovery involves
Recovery differs between patients. What follows is what usually happens — your own timeframe is given at discharge, based on the operation you actually had.
- Hospital stay is usually longer than for a straightforward groin or navel hernia.
- Swelling and firmness over the repair can persist for some weeks.
- Activity restrictions are more prolonged, and the specific period is given at discharge.
- Weight control and avoiding heavy straining help protect the repair long term.
When to go to hospital instead
Sudden pain over the bulge, a swelling that becomes hard and irreducible, or vomiting — go to a hospital the same day.
Common questions
Questions patients ask
Anything not covered here can be answered at the consultation.
01 Why did a hernia form at my old operation scar?
The muscle layer heals with scar tissue, which is not as strong as the original. Infection at the time of the first operation, wound problems, heavy straining, smoking and weight gain all make it more likely.
Cause02 Are these repairs harder than a normal hernia?
Generally yes. There is scar tissue and often adhesions from the previous surgery, the defect can be irregular, and a wider area of the abdominal wall may be weak. That is why a CT scan is usually done before planning.
Complexity03 Can it be done by keyhole?
Sometimes. It depends on the size and position of the defect and on how much scarring there is inside. Where open repair gives safer access, that is what is recommended and the reason is explained.
ApproachNext step
Bring your reports to a consultation
Often one visit is enough to know whether an operation is needed at all.