Incisional hernia

incisional hernia
• incisional hernia happens when a
weakness in the muscle of the
abdomen allows the tissues of the
abdomen to protrude through the
muscle.
• Abdominal surgery.
• They happen after up to 15-20%.
 Causes
•  muscle doesn't heal, so a gap opens up
as the muscles tighten and release during
activities.

• An incisional hernia is typically small

enough that only the peritoneum, or the
lining of the abdominal cavity, pushes
through.
• In severe cases, portions of organs may
move through the hole in the muscle, but
this is much less common.
Risk factors.
•  History of multiple abdominal surgeries.
• Obesity.
• Pregnancy.
• Activites that increase abdominal
pressure.
• Smoking.
• wound infection.
Diagnosis
• Ultrasound.
• CT.
 Types
• Reducible hernias can be pushed back in. They
may also shrink when you lie down.
• Irreducible hernias happen when part of your
intestine pushes into the hernia, making it hard
to push the hernia back in.
• incarcerated hernia:A hernia that gets stuck in
the "out" position.
• strangulated hernia, where the tissue that
bulges out is being starved of its blood supply/
Surgical Treatment.
• Open repair.
• Laparoscopically.
 factors to decide which mesh
placement 

• Size of the hernia and gap made by the

hernia;
• Underlying conditions of the patient;
• Overall medical status of the patient; and
• Surgeon preference.
 Onlay mesh placement
• Onlay mesh placement is a technique to
surgically repair a hernia.
• The mesh is used to strengthen the repair
and reinforce the abdominal wall. The
mesh is placed overlying the defect
(opening) made by the hernia.
 Inlay mesh placment
• The inlay technique involves placing the
mesh between the edges of the fascia
where the defect made by the hernia is.
• Inlay placement does not actually close
the gap, rather the mesh is fixed with
sutures to the edges of the gap to bridge
the defect.
Underlay mesh placement.
• The underlay technique involves placing
the mesh on the underside of the gap or
inside the fascia.
• Because of this technique, it is also
referred to as the inside-out technique for
hernia repair.
Retromascular hernia repare.
• The mesh can then be placed in the
retromuscular space.
References.
• https://digitalsurgery.com/2021/01/20/mis
sion-incision-open-retromuscular-repair-o
f-a-ventral-incisional-hernia
/.

• https://
www.healthline.com/health/incisional-her
nia#treatment
.

• https://
www.verywellhealth.com/what-is-incision
al-hernia-3157228
.