Risk Factors and Prevention of Incisional Hernia

Abstract

Patients requiring abdominal surgery can be operated via open surgery, laparoscopic surgery or surgery through an natural orifice. In case of open surgery, the midline incision is the most frequently used incision for gaining access to the abdomen. At the end of surgery the abdominal wall will be sutured to ensure that abdominal contents remain in their original place. After closure of the abdomen the surgeon will sometimes opt to close the subcutaneous fat layer separately, after which the skin will be closed via suture or staples. In case of failure of the abdominal wall closure the contents of the abdomen may protrude through the defect causing a possible bulge and symptoms to occur. This failure or incisional hernia (IH) is defined by the European Hernia Society as an abdominal wall gap with or without a bulge in the area of a postoperative scar perceptible or palpable by clinical examination and/or imaging.