Ventral Hernia: Overview, Symptoms, Types, Treatment & Repair

Overview

• Definition: A ventral hernia is a hernia that occurs through the front abdominal wall.
• Types:
  • Epigastric hernias: Occur in the upper abdomen between the belly button and breastbone.
  • Umbilical hernias: Occur around the belly button, often congenital.
  • Incisional hernias: Occur at the site of a previous surgical incision.

Symptoms and Causes

Symptoms

• Visible bulge in the abdominal area, especially during:
  • Laughing, crying, coughing, sneezing.
  • Bending, lifting, exercising.
• Possible sensations include a tug, dull ache, or sharp pain.
• Complicated hernias may cause nausea, vomiting, redness, or rash.

Causes

• Congenital weak spots.
• Connective tissue diseases, aging, muscle degeneration.
• Chronic obesity, coughing, constipation, or breathing difficulties.
• Abdominal injury or surgery.
• Pregnancy and childbirth.
• Jobs requiring frequent lifting or pushing.

Complications

• Hernias may get stuck or incarcerated, leading to tissue death or blocked intestine.

Diagnosis and Tests

• Diagnosis is often made during a physical exam.
• Imaging (ultrasound, CT scan, MRI) may be used to assess the hernia.
• Examination may involve checking if the hernia can be pushed back in.

Management and Treatment

Repair Necessity

• Most ventral hernias should be repaired eventually.
• Immediate repair needed if hernia can't be pushed back, or causes frequent symptoms.

Surgical Repair Methods

• Open ventral hernia repair: Traditional method with direct access to the hernia.
• Laparoscopic repair: Minimally invasive with small incisions and camera assistance.
• Robotic repair: Uses robotic hands controlled from a console, also minimally invasive.

Use of Mesh

• Mesh may be used to reinforce the abdominal wall.
• Types of mesh:
  • Synthetic mesh: Permanent, durable.
  • Biological mesh: Made from human or animal tissue, less durable.
  • Bioabsorbable synthetic mesh: Temporary support until healing.

Alternatives

• Surgery is the only repair method but may not be possible for everyone.
• Special apparatus like a corset may be used for those unable to undergo surgery.

Outlook / Prognosis

• Ventral hernias can become serious if untreated.
• Elective surgery is preferable for better outcomes.
• 10-20% chance of recurrence after repair.

Cleveland Clinic Care

• Offers minimally invasive hernia repair and abdominal wall reconstruction.

Reviewed on 06/30/2023. Information provided by Cleveland Clinic, a non-profit academic medical center.