Ventral Incisional Hernias Aka Hernias Caused By Prior Surgeries

Abdominal Surgery in the past can predispose one to a Ventral Incisional Hernia. This means that a hernia has formed in the area where the original surgery incision was made. This occurs because the prior surgery weakens the abdominal wall, and sometimes results in a Ventral Hernia.

Hernias occurring in this fashion need to be repaired in a surgical fashion. They will not go away on their own, and they never get smaller. Either the hernia will stay the same size, or enlarge as time goes on.

This type of hernia can be repaired laparoscopically, or in an open fashion. Both occur most often with mesh.

Advantages and disadvantages exist with both methods. If the hernia is small and is amenable to laparoscopic repair, this can be done. However, larger hernias often need an Open Repair, often with a Rives technique, as this method places the abdominal structures, muscle and fascia, back into their anatomic positions. Known as an Abdominal Wall Reconstruction, this is the most effective way to repair the defect to give the patient as close to their original function as possible. This method brings the rectus muscles, which have often been pushed by the hernia into a lateral position, back to their proper position in the mid-line of the abdomen. In addition, during the repair, the mesh is placed in between the layers of the abdominal wall, thereby protecting the intra-abdominal structures from the mesh.

Abdominal Wall Reconstruction is ideal for the young, healthy, active patient. Although the recovery is somewhat longer, the overall benefit is that the abdominal structure and function is vastly improved. Surgeons performing this technique need to be skilled in creating Myofascial Flaps, and understanding the intricacies and complexities of the abdominal wall.

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