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1. What is the difference between a ventral hernia and
an incisional hernia ?
An incisional hernia simply refers to a hernia where a
previous incision took place. Frequently, this is the ventral surface of the abdominal wall and so the terms mix.
In either case, it is a defect through which a bulge takes place. This bulge could have intestine within and thus,
needs repair.
2. What is an epigastric hernia?
This is a hernia not due to a previous incision along the midline of the abdominal wall. They too are a form of a ventral
wall hernia. The repair is similar to the classic ventral hernia.
3. Should I have laparoscopic
repair or traditional approach?
This can only be properly answered after consultation
and exam by the surgeon.
4. Why did the surgeon leave drains after the procedure?
Large hernias sometimes require movement of more tissue which causes release of fluid, often
called serrous fluid which can collect under the skin and make seromas. A seroma is simply the collection of serrous
fluid under the skin. The drain simply helps remove this fluid until its production stops.
5. What if I have swelling and pressure under the skin where the repair was done ?
This is related to question 4 above, this type of swelling is not infrequent after ventral hernia repairs and the fluid is
often just serrous fluid which can be aspirated by a needle if it becomes troublesome. Eventually, the body will reabsorb
it on most occasions.
6. Why do I need to stay in the hospital ?
Larger repairs usually do require intravenous pain medication. If the intestine was involved in the hernia, taking
down scar tissue or adhesions sometimes takes a few days for the intestine to regain its function.
7.
What is the chance the repair will not hold and the hernia recurs ?
Today, most repairs are
done with mesh material which has greatly reduced the recurrence rates. In the past, without mesh, repairs were done
by trying to pull muscle together, often under tension which can lead to pulling apart and recurrence. Mesh
repairs avoid tension and so less pain and less recurrence has resulted.
8.
What are some of the risks ?
This is better answered on an individual basis via consultation
with the surgeon.
9. When can I return to work, activity, exercise ?
Again, some ventral hernia repairs are larger than others but most surgeons would recommend avoiding heavy lifting (what you
perceive as straining) for a minimum of 3-6 weeks. Routine activities can often be resumed much sooner.
10. What about pain control?
Larger repairs initially often
require hospitalization for adequate pain control. Once oral pain medication can handle the discomfort, the patient
can go home. A more extensive repair may require increased length of hospital stay and the amount of time
pain medication needed at home. Stool softners while taking pain medication is recommended to avoid constipation.
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