What is a Ventral Hernia Repair?
A ventral hernia is a hole in the tough protective covering (fascia) of the abdominal muscles. When this hole occurs at the belly button (umbilicus), it is called an umbilical hernia. When a hernia develops, the intra-abdominal contents, including the intestines, can protrude through the hernia defect. On occasion, the intra-abdominal contents become stuck (incarcerated) in the hole and cannot be returned to the abdominal cavity. This can become a surgical emergency. For this reason, known hernias, particularly those that are symptomatic or susceptible to becoming incarcerated, should be repaired.
Who is a candidate for a Ventral Hernia Repair?
You may want to consider a ventral hernia repair if you have:
- A ventral hernia that is the result of genetics, pregnancy, or previous abdominal surgery
- A ventral hernia that is symptomatic – tender, occasionally incarcerated (stuck), or that interferes with bowel habits
- The ideal hernia repair patient is in good health, a nonsmoker, and at a healthy, stable weight.
How is a Ventral Hernia Repair Performed?
The incision for a ventral hernia depends on where the hernia is located. If the hernia is small and localized to the belly button area, an incision can be made just around the belly button. The hole in the fascia is identified and closed with sutures. Larger hernias may be amenable to minimally invasive techniques with mesh reinforcement. Very large hernias require a large midline incision, re-approximation of the abdominal muscles, closure of the defect, and placement of a mesh prosthesis for reinforcement.
All surgery is associated with risks. Risks associated with ventral hernia repair include bleeding, mesh infection, damage to intra-abdominal contents, scarring, and hernia recurrence. Large hernia repairs are at a much higher risk for all complications. In addition, large hernia repairs have an increased risk of systemic complications including blood clots, pneumonia, and pulmonary failure. It is important to talk with Dr. Rovelo about the risks of your individual surgery and how the risks can be minimized to provide the best possible outcome.
Small umbilical hernias can be repaired in an outpatient surgical setting, under general anesthesia. Surgery takes about 1 hour and the patient can go home the same day. Patients will be seen in clinic in one week. Larger hernia repairs will need to be performed in a hospital setting and these surgeries can take between 2-6 hours. These patients will need to remain in the hospital for 2-7 days. After hernia repair, an abdominal binder will need to be worn at all times for 6 weeks. No strenuous activity or heavy lifting should be performed during this time.