What is an incisional hernia?
An incisional hernia is a type of hernia that occurs when part of the abdominal contents protrudes through a weakened area of the abdominal wall —usually at the site of a previous surgical incision.
This happens when the scar from the surgery doesn’t heal with enough strength, leaving a fragile spot where tissues can push through over time.
Why does an incisional hernia occur?
The most common cause is poor healing of the abdominal wall after surgery. Several factors can contribute to this weakness:
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Infection in the surgical wound
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Obesity or increased intra-abdominal pressure
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Chronic coughing or repeated physical strain
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Diabetes, which affects tissue healing
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Smoking, which reduces oxygen delivery to tissues
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Naturally weak abdominal muscles
All these factors can interfere with proper scar formation, increasing the risk of developing a hernia at the incision site.
Typical symptoms
The main symptom is a bulge or lump in the area of the surgical scar, which may:
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Increase when coughing, standing up or lifting something heavy
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Reduce when lying down
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Be associated with discomfort, tightness or pain
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Sometimes remain unnoticed until complications arise
In mild cases, the hernia may not cause major discomfort, but if left untreated, it often grows or becomes more problematic.
Possible complications
The most serious complications include:
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Incarceration: the herniated tissue gets stuck and cannot be pushed back in
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Bowel obstruction: if part of the intestine becomes compressed
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Strangulation: when blood flow to the trapped tissue is compromised, leading to tissue death
These situations can cause severe pain and require emergency surgery.
How is an incisional hernia treated?
Treatment is always surgical, since the abdominal wall does not heal on its own. The two main techniques are:
1. Open surgery
The surgeon makes an incision over the affected area to repair the hernia. A synthetic mesh is often placed to reinforce the abdominal wall and reduce the risk of recurrence.
2. Laparoscopic surgery
This is a minimally invasive approach using small incisions and a camera. Many patients recover faster and experience less postoperative pain.
Which technique is best?
There is no one-size-fits-all answer. The choice depends on:
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The size and location of the hernia
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The patient’s medical history
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Presence of complications
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Overall health and risk factors
Your surgeon will assess your case in detail and recommend the safest and most effective option for your recovery.
If you notice a bulge or discomfort in a surgical scar, schedule a medical evaluation to confirm the diagnosis and discuss the most appropriate treatment.