Ventral Hernia

What is a ventral hernia?

Ventral hernias occur on the anterior abdominal wall (front of the abdomen). These hernias typically happen because of weak areas in the abdomen. Common causes of ventral hernias include:

• Prior surgery
• Coughing
• Heavy lifting
• Obesity
• Smoking
• Other disorders

Types of ventral hernias

There are several different types of ventral hernias, including:

Umbilical hernia

One of the most common types of hernias, an umbilical hernia is a bulge appearing at the navel or belly button.

Epigastric hernia

An epigastric hernia is a bulge occurring in the middle of the abdomen above the belly button and below the breast bone. These hernias typically only contain fatty tissue. They are often quite small and may be difficult to diagnose because the defect is often only a few millimeters in size.

Incisional hernia

An incisional hernia occurs at the site of a prior abdominal incision. These occur in up to 10 percent of patients that have undergone prior abdominal surgery.

Parastomal hernia

A parastomal hernia occurs at the site of a colostomy, ileostomy or other stoma (intestines sutured to the skin). These hernias may be repaired or occasionally may require moving the stoma to a new location. If possible, the stoma should be reversed to treat this condition.

Spigelian hernia

A Spigelian hernia occurs in the lower quadrants of the abdomen, usually at or below the level of the belly button and slightly to either side. Spigelian hernias occur through a natural weakness in the abdominal wall. In most cases, the hernia does not occur through all of the muscles of the abdominal wall, making them more difficult to diagnose. CT scans, ultrasounds and occasionally laparoscopic surgery are required to confirm the diagnosis.

Treating ventral hernias

Hernias are repaired with either conventional open surgery or minimally invasive (laparoscopic) surgical techniques. Almost all ventral hernias may be repaired using a laparoscopic approach. Laparoscopic surgery is performed by making several small incisions on the abdomen.

There are several advantages to using laparoscopic ventral hernia repair versus a large incision:

• Quicker recovery time
• Decreased length of hospital stay
• A quicker return to normal activities
• Fewer incidences of hernia recurrence
• Fewer infections

Because of the overwhelming advantages of laparoscopic repair, consideration should be given to repairing all ventral hernias utilizing the laparoscopic approach.

Incisional hernias and other ventral hernias larger than three centimeters are repaired with a strong, flexible synthetic material called mesh, which is used to fix the defect or hole in the tissues. The mesh is secured to the abdominal wall to reinforce the weakened area.