"Ventral hernia" is a term used to describe a protrusion of tissues or intestine through a weak spot in the abdominal wall. There are two types of ventral hernias: umbilical and incisional.
Ventral Hernia Compared to Other Types
There are several types of hernias, typically classified based on where in the body they are located. Ventral hernias are located anywhere in the anterior (front) abdominal wall. They develop when muscles in the abdominal cavity weaken, or there is an opening that allows the tissue or intestines to push through.
Not all ventral hernias will cause symptoms, and in milder cases, the protrusions can be moved back into position manually without the need for surgery.
In cases in which a ventral hernia does cause symptoms to develop, symptoms can include:
- Abdominal pain around the protrusion that can worsen during physical activity
- A physical lump or bulge in the abdomen
- Constipation, depending on where it is located
- Nausea and vomiting
What Type of Pain Does a Ventral Hernia Cause?
Typically, the sensation felt when a ventral hernia develops is sharp pain in the abdominal area where the hernia is located. It could also feel like a dull ache or a pulling sensation.
Hiatal Hernia Surgery: Overview
Who Gets Ventral Hernias?
While anyone can get a ventral hernia, they are most notably caused by:
- Chronic diseases, such as diabetes or obesity
- Chronic or severe coughing or vomiting
- Heavy lifting
- Injuries
- Pregnancy
- Prior surgery in the area
Ventral hernias can also develop congenitally, meaning they are present at birth.
How Prevalent are Ventral Hernias?
Roughly 20% of adults will develop a primary ventral hernia. Following surgery, which is a known risk factor and trigger, that number rises to 30%.
Pregnancy Hernia: Formation During Trimesters or After Delivery
What Repair Involves
Ventral hernias do not always need to be treated right away, but they will not resolve on their own, so over time, they worsen. At this time, surgery will be necessary. Two types of surgeries can be done to repair a ventral hernia, including:
Open Hernia Repair
Open hernia repair involves cutting the abdomen open above the hernia to push the protruding tissue back into place. The surgeon repairs the opening in the muscle wall manually.
Sometimes, a mesh insert is placed to reinforce the muscle wall and prevent the hernia from occurring again.
Laparoscopy
Laparoscopic surgery involves making several small incisions into the abdomen. The surgeon uses a tubelike instrument with a camera on the end to allow the surgeon to get an inside look at the hernia without having to make an invasive cut.
Other tools are guided into the abdomen through the remaining small incisions to repair the hernia. Synthetic mesh and skin glue are often used in this type of procedure to reinforce the muscle wall and repair the hernia. In some cases, this surgery can be performed using robotic arms in what is known as robotic-assisted repair.
Choosing the Surgery That’s Right for You
There are pros and cons to both types of surgeries. Laparoscopy is often considered superior because there is less recovery time and post-op discomfort. Your healthcare provider will discuss your options with you so you can reach a decision that will likely be the best outcome.
Hernia Surgery: What to Expect on the Day of Surgery
Surgical Complications
Several complications are associated with ventral hernia repair surgery. The typical ones, which can occur after any type of surgery, include bruising, bleeding, and infection. A seroma, an accumulation of fluid where the hernia used to be, can also occur. Most seromas will heal on their own; however, some may require separate surgery.
Other possible complications that can occur following ventral hernia surgery include:
- Pain
- Injury to blood vessels or nearby organs
- Issues with the mesh, such as it moving from its spot or breaking down within the body
- Recurrence of hernia
How Common Is Hernia Recurrence?
According to research, rates of ventral hernia recurrence are high following surgery. They range from 30% to 80%.
Diagnosis After an Unrelated Surgery
Incisional hernias, which are types of ventral hernias, develop following surgery in the abdominal area for something unrelated. They occur when the abdominal wall does not heal adequately, leaving space or a weakness near the incision. After developing a hernia after an unrelated surgery, a person will need a second surgery to fix the hernia.
How Common Are Incisional Hernias?
Roughly five to 15 out of every 100 people will develop an incisional hernia following surgery for another reason.
After Surgical Repair
If a person develops a hernia after surgery, they will need another surgery to fix it. If the incisional hernia develops a few weeks after the first surgery, it will be left alone so that the abdominal wall can recover. Typically, incisional hernias are treated only after a few months have passed after the initial surgery.
Post-Op Instructions
People should avoid straining the abdomen in any way, either through exercise or heavy lifting, for at least a few months after surgery. It may also be advised that a person lose weight after surgery to reduce pressure in the abdomen. People should also avoid smoking, as this can lead to a lengthier healing time and worse wound healing, which increases the risk of a hernia developing.
Recovery Timeline
The timeline for recovery will depend on the individual’s ability to heal. Typically, though, it takes roughly a few months from the time of surgery to reach a full recovery.
How Much Time Will I Have to Take Off Work?
Typically, people can gauge how well they feel to return to work. However, it is suggested that people take at least one to two weeks off to allow the site to heal without putting added strain on the area. Always speak to your healthcare provider to get the go-ahead before returning to your regular activities, including work.
Hiatal Hernia Surgery: Recovery
Complications From Untreated Symptoms
You should never leave a ventral hernia untreated. While treatment isn’t always done immediately, the ventral hernia will require surgery at some point. Ignoring symptoms may put you at risk for a condition known as strangulation
Strangulation occurs when the blood supply to the ventral hernia is reduced or cut off entirely, causing the tissue in the hernia to die. Symptoms of strangulation include:
- Excessive or profuse sweating
- Fever
- Rapid heartbeat
- Severe nausea and/or abdominal pain
- Vomiting
Summary
A ventral hernia occurs when there is a weakness or opening in the abdominal cavity and the intestines or other tissues protrude through, causing a bulge. These hernias can be both symptomatic or asymptomatic. In some cases, if there are no symptoms, people can avoid having surgical treatment for some time. Eventually, though, all ventral hernias will require treatment.
Surgery is the only way to treat a ventral hernia and there are two options to choose from. You and your healthcare provider will work together to choose the one that’s best for you based on the severity of the hernia, the risk factors you have for recurrence, and your current state of health.