An incisional hernia occurs when tissue pushes through a weakness at the site of a previous abdominal operation. You may notice a bulge beneath or beside a scar, discomfort when coughing or lifting, or a change in abdominal shape. Incisional hernias range from small defects to complex problems involving scar tissue and muscle separation. A specialist assessment defines the extent of the weakness and the safest treatment options.
Assessment and surgical planning
Your consultation includes a review of previous operations, symptoms, medicines and factors that may affect healing. CT imaging is often useful for larger or recurrent incisional hernias because it shows the size and location of the defect, the abdominal muscles and any previously placed mesh. Before surgery, your team may recommend stopping smoking, improving diabetes control, optimising nutrition or reducing weight to lower avoidable risks.
What does repair involve?
The surgeon returns the hernia contents to the abdomen, releases scar tissue where necessary and reconstructs the abdominal wall. Mesh reinforcement is frequently used because incisional hernias have a meaningful risk of recurrence, but its position and material are selected for the individual case. Surgery may be open, keyhole or robotic where available and appropriate. Large or complex defects may require advanced techniques to bring the abdominal muscles back towards the midline.
Recovery after incisional hernia surgery
Recovery depends on the size and complexity of the repair. Some patients go home the same day, while major reconstruction may require a hospital stay. Walking and breathing exercises begin early to reduce complications. Pain, tightness, bruising and swelling are expected initially. You will receive guidance on wound care, support garments if recommended, lifting restrictions and a gradual return to work and exercise.
Possible risks
Complications can include bleeding, infection, seroma, delayed wound healing, skin problems, bowel injury, blood clots, persistent pain, mesh complications and recurrence. Larger operations may also affect breathing or bowel function temporarily. Your surgeon will explain your individual risk profile and the steps taken to reduce complications.
Frequently asked questions
Does every incisional hernia need surgery? No. The decision depends on symptoms, size, progression, general health and the balance of surgical and non-surgical risks.
Why is mesh often recommended? Mesh can reinforce weakened tissue and reduce recurrence compared with suture repair in suitable patients, but it also carries specific risks that must be discussed.
Can the old scar be improved? The previous scar may sometimes be revised during repair, but this depends on blood supply, tissue quality and the operative plan.