Hernias are abnormal profusion of the internal contents of abdominal ( visceral cavity) from the muscular defect in the body. There are various types of hernias which are divided basically on the site of the hernia in the body and the organ/ contents involved in the hernia.
The hernia occurring in the abdominal wall of the body is defined as ventral hernias which are among the second type of hernias in the body. They are most common in female patients in middle aged patients but also encountered frequently in male patients. The ventral hernias are further divided in to paraumblical hernia, supra umbilical hernia, epigastric hernia , lumbar hernia and most commonly encountered incisional hernia.
Common causes and risk factors for ventral hernia
- Female patients especially post delivery / Caesarean section surgery
- Smoking leading to weakness of collagen of body.
- Chronic constipation.
- Chronic cough .
- Wound infections after primary surgeries
- Congenital and anatomical defects in Umblicus
- Heavy weight lifting/ labour’s which deal with heavy weight on routine basis
- Collagen deficiency disorders
- Recurrent incisional hernia due to poor healing and unhealthy musculature of body
Common symptoms of ventral hernia
- swelling or bulge in the abdomen commonly at umbilicus and previous incision site
- Swelling increased with straining and decreased with lying down
- Continuous dull aching or dragging pain in swelling
- Severe pain in case of contents of hernia getting obstructed
- Symptoms of complications associated with contents of hernia such small intestine and large bowel.
Diagnosis and investigations
These symptoms should not be ignored and you should meet your surgeon/ clinician for further examination. Since, hernia is a clinical diagnosis based on the examination of the patient, routine investigation like blood tests, ultrasonography of the abdomen is done to rule any other associated problems of abdomen. Contrast enhanced computerised tomography (CECT) abdomen is advised in case of large ventral hernias and recurrent cases of hernias where there may be chances of internal complications and to assess the size of the defects with underlying contents of the hernia.
Treatment of ventral hernia
The mainstay treatment of hernia is surgery which is done by minimal access methods( laparoscopic/ robotic surgery ) at many hospitals across the world. The routine conventional surgery is also been practised at various centres. Routine conventional surgery is preferred for very large ventral hernias more then 7-10 cm defects, multiple defects and in case of multiple previous surgeries.
Laparoscopic surgery gives an advantage of early recovery to the patients, painless procedure , minimal scar and patient returns to activity with in 3-7 days of surgery . There are different types of minimal access surgery in spectrum of surgeon as the choice depends upon size , location of the hernia and patients factors.
Recovery after surgery
Hernia surgeries are practised on day care basis or patient is discharged in 1-2 days. Patient can consume normal diet from the next day of surgery. They can resume normal routine once they start feeling comfortable with their pain on medications. Early mobilisation is encouraged. Patients may be advised for wearing abdominal binders in case of large ventral hernia for abdominal support.
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