Incisional hernia is a condition in which a piece of abdominal organ, such as the intestine, protrudes through an opening at the site of a surgical scar on the abdominal wall. According to a study published in the February 2003 issue of the "Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland," it is commonly seen after closing an abdominal wall following surgery. Incisional hernias must be repaired, but even the procedure to repair an incisional hernia has its own set of complications.
Seroma
Seroma, a tumor-like accumulation of fluid within the tissue, can be caused by the inflammatory reaction of the patient's body to the mesh, a net-like, prosthetic material, used in incisional hernia repair. Using a mesh with larger pore size can reduce the incidence of seroma formation post-operatively, according to the book "Abdominal Hernias: Principles and Management" published in 2001.
Recurrent Hernia
According to the "Complications of Surgery," a book published in 2006, a recurrent hernia can sometimes develop after an incisional hernia repair. Certain risk factors which may contribute to another hernia recurring include not using mesh in the initial hernia repair and a prior skin infection at the incision site. This infection can alter normal collagen deposition, which is an important aspect of wound healing. Other contributing factors are smoking and obesity, which increases intra-abdominal pressure, leading to bulging of the hernia through the newly repaired abdominal wall. Eliminating the risk factors decreases the risk of this complication and the tendency of hernia to recur.
Persistent Postoperative Pain
According to a study published in December 2004 in "Hernia: The Journal of Hernias and Abdominal Wall Surgery," post-operative pain can occur in 1 to 2 percent of cases. Pain may be due to unintentional damage through accidental incision of minute nerve endings distributed within the surgical wound site during operation. However, taking pain relievers and medications for nerve pain can provide temporary relief. In some cases, cryoanalgesic ablation can be considered, a procedure which blocks nerve sensation to the body region.
Hematoma
Hematoma,or localized collection of clotted blood, can occur in one to five percent of patients undergoing laparoscopic incisional hernia repair, according to the book "Prevention and Management of Laparoendoscopic Surgical Complications." Hematoma can be caused by accidental puncture of superficial blood vessels within the abdominal wall. Stopping the source of bleeding by using electrocautery during the surgical procedure is the best way to prevent the occurrence of hematoma post-operatively. However, if large hematoma formation is noted after the operation, aspiration may be required to resolve the problem.
References
- "Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland"; Factors involved in abdominal wall closure and subsequent incisional hernia; O'Dwyer, P.J. et al.; February 2003
- "Abdominal Hernias: Principles and Management"; Robert Bendavid et al.; 2001
- "Complications of Surgery"; M.W. Mulholland et al.; 2006
- "Hernia: The Journal of Hernias and Abdominal Wall Surgery"; Laparoscopic incisional and ventral hernia repair: complications-how to avoid and handle; LeBlank, K.A.; December 2004
- "Prevention and Management of Laparoendoscopic Surgical Complications"; Paul Wetter et al.; 2005
