Incisional hernia

Last revised by Dr Subhan Iqbal on 17 Jun 2021

Incisional hernias (alternative plural: herniae) are relatively common and along with parastomal herniasumbilical herniasparaumbilical hernias, and Spigelian hernias, they are usually anterior abdominal hernias.

Incisional hernias usually develop within a few months of surgery, but a small proportion can remain clinically silent for years. They typically occur after laparotomy with rates of ~2-20% 5.

Numerous risk factors for developing an incisional hernia have been identified 4:

  • preoperative factors: increasing age, female gender, BMI >25, increasing thickness of subcutaneous fat based on CT, preoperative chemotherapy
  • intraoperative factors: midline incision, contaminated or infected wound noted during procedure, intraoperative blood loss
  • postoperative factors: surgical site infection

Incisional hernias occur most frequently through previous laparotomy scars (other incisional hernias are possible, such as a lung hernia). Widening or dehiscence of the scar allows intra-abdominal contents to herniate into the subcutaneous tissues.

Current literature endorses that surgical repair for incisional hernia is taken up to cause improvement in the quality of life of patients 5.

Complications are similar to other hernias and include incarceration, strangulation and intestinal obstruction.

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Cases and figures

  • Case 1: right iliac fossa appendectomy scar hernia containing colon
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  • Case 2
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  • Case 3: parastomal hernia
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  • Case 4
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  • Case 5
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  • Case 6
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  • Case 7: port site hernia
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  • Case 8: lumbar hepatic
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  • Case 9: Incisional hernia
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  • Case 10: SBO due to large suprapubic incisional hernia
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  • Case 11: incarcerated trocar site hernia
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