- An incisional hernia is a weakness in the lining of the tummy in the scar of a previous operation. This can be a small defect or involve a longer portion of the old operation.
- Incisional hernias tend to increase in size over time and the larger they become the more difficult they are to repair.
- There is a risk of bowel becoming trapped or twisted within the hernial sac which can lead to obstruction and impairment of the blood supply to the bowel, requiring an emergency procedure to salvage the bowel and avoid a life-threatening condition.
The surgeon will make an incision at the hernia site and move tissue, intestines and any other organs that are involved in forming the hernia back into the abdominal cavity. A synthetic material patch is inserted in the area of weakness to reinforce the spot where the hernia developed. This patch is secured to the tissue surrounding the hernia and the wound is closed over two drains in large hernias and one drain in smaller hernias.
- Bowel injury – usually a careful release of adherent bowel is required, the adhesions having formed following the previous surgery, and sometimes these can be very challenging for the surgeon.
- Wound infection – the procedure is done under antibiotic cover. If a wound infection does develop this can require prolonged wound dressings, and sometimes removal of any synthetic mesh used to repair the hernia.
- Delayed return of bowel function particularly if extensive freeing up of bowel adhesions is necessary.
- Recurrence of the hernia, even if a mesh repair is performed.
- Seroma formation – collection of fluid between the muscle repair and the skin that may need aspirating in the rooms on one or more occasions.
- Other complications include: Deep vein thrombosis, pulmonary emboli, atelectasis, and pneumonia.
After your consultation:
- Obtain authorization from your medical aid and book your bed for your hospital admission.
- Carefully read through pre-operative information provided.
Day before surgery:
- Do not eat/drink after 22h00, the night before your surgery, unless otherwise specified by your surgeon or anaesthetist (you should be fasting for at least 6 hours before the procedure for solids but you are allowed to take clear liquids up to two hours before your procedure).
Day of surgery:
- Arrive for admission at indicated time on ‘Code & Consent’ sheet.
- Change into theatre attire, remove all valuable belongings.
Approximately 1-4 hours, this depends on the size and complexity of the hernia.
Duration of hospital stay:
- 2-5 days (dependent on pain management, general state of patient and first bowel movement).
- Refrain from strenuous activities (incl. exercise) for at least 4 weeks post-operatively.
Back to work:
- Sick leave required post-operatively is approximately 7-14 days.
Some pain and discomfort post operatively may be expected following any operation, but the following measures are used to lessen the pain experienced:
- Warming devises in theatre as well as warm intravenous fluids.
- Intra-operative pain medication through the drip.
- Post-operative medication through the drip, please inform the nurses if you are in pain so that medication will be administered to you.
- As close to one week after discharge as possible. Please contact the rooms to schedule an appointment.