Incisional hernias occur through or around the site of previous operative scars.
The symptoms and complications are similar to other herniae, ranging from a bulge to strangulation.
They occur for a number of reasons:
- Poor surgical technique
- Postoperative wound infection
- Obesity
- Patient debility
- Smoking
Commonly they recur as well!. This high failure rate for open repair has driven the procedure of laparoscopic incisional hernia repair.
A special mesh, with a non-adherent coating is employed to minimise the possibility of bowel sticking to the underside of the mesh.
The technique being similar to that of laparoscopic umbilical hernia repair
The advantages of laparoscopic repair are:
- Operating on relatively undisturbed tissue
- Large tension-free mesh insertion
- Identification of additional herniae
- Sublay mesh insertion
Sublay mesh insertion has advantages over onlay mesh insertion beyond the size of mesh used. In mechanical terms the repair is more robust if the mesh is placed under the area of weakness, rather than on top of it.
