Conditions/Hernia Disease/Chapter
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.
Key points
- What it isTap for details
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).
- Why it developsTap for details
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 risksTap for details · 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 planningTap for details
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 approachTap for details
Most symptomatic incisional hernias need mesh-based abdominal-wall reconstruction. Open repair, laparoscopic/IPOM-style approaches, robotic assistance, or hybrid techniques are chosen by defect size, location, contamination risk, and fitness. Complex cases may need component separation or other extended reconstruction.
- Why it is not a “simple hernia”Tap for details · 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?Tap for details
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?Tap for details
Selected tiny asymptomatic defects may be observed. Symptomatic, enlarging, or high-risk hernias are usually repaired.
More chapters in this hub
Inguinal (Groin) Hernia
Groin bulge, TEP/TAPP/open options, and when to seek urgent care
Umbilical Hernia
Navel bulge — when size and symptoms push toward repair
Hiatal Hernia
Stomach in the chest — reflux and anti-reflux repair
Balloonless TEP Hernia Repair
Total extraperitoneal repair without balloon dissection
Hernia Surgery Methods
Open, TEP, and TAPP — how surgeons choose an approach
Robotic Hernia Repair
Robotic hernia repair: what the procedure aims to do and who it fits
Appointment / info
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.