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Assoc. Prof. Cengiz Dibekoğlu, MD

General Surgeon · Laparoscopic · Robotic · Oncologic Surgery

Detailed chapter

Hernia Disease — Incisional Hernia

Hernia through a prior abdominal incision — planning beyond “closing one hole”

An incisional hernia forms when the abdominal wall fails along a previous surgical scar and bowel or fat protrudes. Single or multiple defects, adhesions, and loss of domain make planning more complex than a simple groin repair.

Incisional hernia · educational illustration

Outcomes of any surgical or interventional procedure may vary from person to person. Please seek a detailed consultation with your physician before any procedure.

© Cengiz Dibekoğlu — illustrative; not for unauthorized use

Figure summary

  • This educational figure shows: Incisional hernia.
  • Related figures on this page: Related: ventral hernia / IPOM technique.

Related educational figures

Tap a figure to enlarge.

  • Related: ventral hernia / IPOM technique

    Educational schematic. Some structures may be simplified or emphasized for clarity; not an exact anatomical depiction.

    © Cengiz Dibekoğlu — illustrative; not for unauthorized use

    Figure summary

    Related: ventral hernia / IPOM technique

Key points

  • What it is

    After laparotomy or other abdominal surgery, if the closure line weakens, contents push through the scar. There may be one opening or several side by side. Advanced cases can show wide wall loss and organs stuck in the sac (adhesions). Incisional hernia is an important subtype of ventral (anterior abdominal wall) hernias — it is not the same as an umbilical or epigastric primary defect.

  • Why it develops

    Wound infection, hematoma, seroma, obesity, smoking, diabetes, malnutrition, steroids or immunosuppression, emergency surgery, closure technique, and large incisions raise risk. Repeat operations further weaken the wall.

  • Symptoms and risks

    Key note inside

    A bulge in the scar, pain, difficulty dressing, limited movement, and cosmetic concern are common. Adhesions raise bowel-obstruction risk. Incarceration, skin ulceration, and rarely fistula can occur.

    • Scar bulge that grows with effort
    • Chronic pain or pressure
    • Bloating or obstructive symptoms from adhesions
    • Skin thinning or irritation in large hernias

  • Diagnosis and planning

    Exam confirms the diagnosis; CT often maps defect number and width, muscle loss, and organ relationships before repair. Prior mesh, stoma, or infection history changes strategy.

  • Treatment approach

    Most symptomatic incisional hernias need mesh-based abdominal-wall reconstruction. Open repair, laparoscopic approaches (including IPOM-style techniques in selected cases), robotic assistance, or hybrid methods are chosen by defect size, location, contamination risk, and fitness. Complex cases may need component separation or other extended reconstruction. IPOM and the ventral-repair schematic are explained on a separate page.

  • Why it is not a “simple hernia”

    Key note inside

    Closing one hole may not be enough. Multiple defects, thinned muscle, adherent bowel, prior mesh, and skin problems are managed together. There is no single standard operation — imaging and experienced planning matter.

Frequently asked questions

  • Is robotic repair always better?

    Not always. Robotics can help precise suturing and difficult angles in selected complex or recurrent defects; suitability is individualized.

  • Can I watch a small scar bulge?

    Selected tiny asymptomatic defects may be observed. Symptomatic, enlarging, or high-risk hernias are usually repaired.

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This page is for education. It is not medical advice and does not replace a visit with your physician.

Medical editor: Assoc. Prof. Cengiz Dibekoğlu, MD · Last medically reviewed: August 2026 · English patient-education chapter.

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