Incisional hernia: preliminary observations at a new institute

Abstract

Background: Ventral hernia develops when an area of the abdominal wall weakens and develops a tear or hole. It may develop as a defect at birth, resulting from incomplete closure of a part of the abdominal wall, or develop where an incision was made during an abdominal surgery, occurring when the incision doesn't heal properly. Incisional hernia is typically observed within the first 5 years after the surgical incision is made, but may develop long afterwards.1 This study was undertaken to review the history and clinical presentations in patients with incisional hernia, and subsequent treatment. Methods: In the present study, the first 20 cases of incisional hernia admitted to this institute for elective herniorrhaphy were studied. History of the previous surgery was obtained and the findings noted. Treatment carried out was included in the study. Results: Out of 20 cases, 12 were female (60%). Mean age of the patient was 41.9±11.9 years. Lower segment Caesarian section was the commonest preceding surgery (7 out of 12 females; 58.33%). Exploratory laparotomy accounted for 5 out of 8 cases amongst males (62.5%). Commonest site of the hernia was infraumbilical (n=9; 45%). Average size of the defect was 6.2 cm x 5.6 cm. 13 patients underwent surgery. Laparoscopic ventral hernia repair was the most common modality used (10 out of 13; 76.9%). Conclusions: Incisional hernia is more common in females, and gynaecological operations are most common cause and most common site is infraumbilical.

A study on clinical profile and risk factors in incisional hernia patients

“…12 Average defect size and average defect area are 7.3x6.5 cm and 47.45 cm 2 respectively. In studies by Subramanian A et al 13 and Huda F et al 14 the average area of the defect observed where 37.9±4.9 cm 2 and 35.63 cm 2 respectively similar to but less than that obtained in our study.…”

Etiology and risk factors of incisional hernia – A prospective study

“…In Tulaskar et al [9] study 71.8% occurred in lower midline incision and 78% incidence were due to gynecological procedures. Cesarean section was commonest preceeding surgery for incisional hernia resulted in Farhanul Hude et al study [12] . In lower abdomen, intraabdominal hydrostatic pressure (20 cm of water) is higher than upper abdomen (8cm of water) in erect posture and absence of posterior rectus sheath were the reason for frequent site of incisional hernia.In our study 38 cases (76%) showed no complication during previous surgery.…”

Bilateral Fat Containing Lumbar Hernia: A Case Report and Literature Review

“…Lumbar hernia is characterized by being reducible and more prominent with increased intra-abdominal pressure such as changing the position to sitting or standing. A contrast-enhanced computed tomography (CT) scan is the gold standard and essential examination for confirming the diagnosis of lumbar hernia as it shows protrusion and hernia sac through the musculature [1,3].…”

“…Thus, in order to establish the diagnosis and formulate proper management, a high suspicion index is needed. This is essential to avoid the significant risk of complications, since 25% will become incarcerated and 8% strangulated [1–4].…”