Ventral hernia
Ventral hernias include lots of different types of hernia, such
as those through or next to the belly button (umbilical or
paraumbilical) and those between the belly button and the breast
bone (epigastric). They also include hernias through the site of a
previous operation (incisional). As with any hernia, they cause a
lump which may cause no other symptoms, can be achy or painful, and
occasionally can cause an emergency problem with severe pain and
potentially other problems such as a blockage in the bowel.
When to repair a ventral hernia
If a hernia is not causing any symptoms other than a noticeable
lump, with no pain or discomfort, it is reasonable to keep an eye
on it without planning an operation. Your doctor can explain the
benefits and risks of this to you. If it is causing symptoms such
as an ache or pain, and you are fit for an operation, you and your
doctor may agree to have it fixed with an operation.
Preparing for an operation
If you are going to have an operation, your doctor will explain
this to you and answer any questions you may have. You will also go
through a pre-operative assessment process which will help give you
more information, as well as an opportunity to ask more
questions.
To help you get the best result and minimise the risks of
surgery, your doctor and the preoperative team may make suggestions
for lifestyle changes. Based upon expert advice produced by the
Danish Hernia Society (available
here), these include:
- Stopping smoking (as soon as possible, but a minimum of 6 weeks
before your operation);
- Losing weight (to achieve a body mass index or BMI below 35
kg/m2);
- Ensuring diabetes is well controlled (HbA1C < 60
mmol/mol).
Repair techniques
There are several different techniques that may be used to
repair a ventral hernia. These include key-hole and open surgery.
Except in small hernias and emergency operations, most ventral
hernias require a mesh to help reinforce the repair and reduce the
risk of the hernia coming back.
Risks
The general risks of repairing a ventral hernia include
bleeding, infection, clots on the legs or lungs, damage to nearby
structures, and the hernia coming back. Specific risks may be
determined by where the hernia is, what is contained inside the
hernia, and other conditions that a person has, such as diabetes or
lung disease. Your doctors will explain more about any benefits and
risks associated with repairing your hernia.
References
Henriksen N A and Helgstrand F. The Danish Hernia Database
(2018). Available at
https://www.britishherniasociety.org/wp-content/uploads/2018/05/COV11339-Danish-Registry-Brochure-05-for-web.pdf
