A ventral hernia is a bulge at the weak point in the abdominal, often at the midline. Though a hernia can occur at any location of the abdominal wall, most common sites for ventral hernias are at the locations of previous abdominal surgeries.
Other types of hernias include:
- Femoral hernia: a bulge in the upper thigh, just below the pelvic area
- Hiatal Hernia: in the upper part of the stomach
- Incisional Hernia: through a scar from a previous abdominal surgery
- Inguinal Hernia: a bulge in the groin area
- Umbilical Hernia: around the belly-button
Do I Have a Hernia?
Symptoms may take weeks or months to appear, and some may never appear at all. A diagnosis is determined based on the patient’s symptoms and imaging tests, showing the presence of a ventral hernia. Sometimes patients have no symptoms, while at other times they will experience discomfort or pain in the area of the hernia. A bulge or growth may be visible in the area that feels tender to the touch. Pain will typically worsen with pressure and heavy lifting.
Risk Factors of a Ventral Hernia
While hernias can develop in anyone, some people are born with a defect, causing the abdominal wall to be unnaturally thin. These individuals are at a greater risk for developing a ventral hernia.
Other risk factors for a ventral hernia include:
- Pregnancy
- Obesity
- History of previous hernias
- Injuries to the bowel area
- Family history of hernias
- Constant lifting/pushing heavy objects
Symptoms of a Ventral Hernia
Ventral hernias can produce an array of symptoms. Some patients don’t feel any symptoms, while others are in severe pain. However, in most cases the visible bulge is the predominant symptom that patients see when diagnosing a hernia.
Symptoms include:
- Mild discomfort in the abdominal area
- Pain in the abdomen
- Nausea
- Vomiting
- For a complete diagnosis, a doctor will perform a physical exam. He or she may need to look inside the body for confirmation.
Diagnostic tests to look for signs of a ventral hernia may include:
- Ultrasound of the abdomen
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI)
Do I Need to Treat my Hernia?
Treatment for a ventral hernia requires surgical removal. Untreated hernias can grow into enlarged ventral hernias that become surgically difficult to remove. Excessive swelling can lead to entrapment of the hernia contents. If left to swell, it can lead to a reduced blood supply to the tissues involved, causing “strangulation.” Strangulation will lead to intense pain, and requires immediate treatment to prevent tissue death (necrosis).
Treatment of Ventral Hernia
Ventral hernias are highly recommended to be fixed unless the patient cannot undergo surgery or refuses it. Ventral hernias will continue to grow slowly until they are able to cause serious complications if left untreated for too long.
Options for surgical treatment include:
- Mesh placement surgery: a surgeon pushes tissue back into place and then sews in a wire mesh to keep it in place; this is considered safe and reliable and allows less tension on the incision.
- Laparoscopic removal: multiple small openings are made and the hernia is fixed using a small camera inside the body to direct the surgery.
- Robotic surgery: hernias can be removed using the most advanced, minimally invasive procedure with the da Vinci robotic surgical system. The surgeon operates using only one incision through the bellybutton by controlling miniature, robotic assisted arms.
- Open surgery (non-laparoscopic): large opening is made so surgeon can enter the body to push the tissue back into place and then sew it.
Benefits of laparoscopic removal include:
- A much smaller cut site (lowers chance of infection)
- Reduced postoperative pain
- Reduced hospital stay (generally able to leave day of or day after procedure)
- Absence of large scar
Some concerns of open surgery include:
- Longer stay in the hospital after surgery
- Greater amount of pain
- Medium to large scarring
Due to the amount of possible complications, I do not recommend open surgery as there are highly advanced laparoscopic alternatives that are faster, safer, and provide quicker recovery.
Complications of Ventral Hernia
A ventral hernia that has grown beyond 10 centimeters is known as a giant ventral hernia and can be a serious surgical risk. The giant hernia fills the abdominal cavity, making it difficult to remove from the surrounding organs. The risk of a reoccurrence also becomes higher with the increasing size.
Outlook of Ventral Hernia
No matter the at-home methods implemented, all hernias require surgery. In the early stages of a hernia, a person may be able to reduce the size of their hernia. Some people may feel the bulge in the abdomen and push the organs back inside but this is only a temporary solution.
The outlook for a patient is generally very good after a surgery with no complications and patients will only need to rest for a few weeks before resuming daily activities.
Outlook is generally very good after a surgery with no complications. Patients may need to rest for a few weeks before resuming daily activities.