- It occurs through a weak surgical or traumatic wound. It is a type of Ventral Hernia. Usually, the incisional hernia presents as a bulge near a previous wound.
- The condition is often asymptomatic but occasionally, presents with pain or strangulation.
- Develops in scar of prior laparotomy or drain site
- Risks for post-operative hernia development
- Vertical scar more commonly affected than horizontal/ Wound infection/ Wound dehiscence/ Malnutrition/ Obesity/ Tobacco abuse/ Presence of drains in wounds/ DM, jaundice, renal failure, immunosuppression/ Malignant disease.
- Incisions commonly affected :
- Lower midline
- Lateral muscle splitting incisions
- C/F: Like any other hernia. May get obstructed and strangulated.
- Smaller incisional hernias (< 3 cm.) can be repaired with primary tissue approximation.
- Repair of larger defects generally requires the use of prosthetic materials, which allows for a tension free repair Q. Laparoscopic techniques may also be used.
- Layer to layer repair - where defect is small to moderate without much tissue loss.
- Keel repair (MAINGOT'S) - Scar is excised. The peritoneum and the layers are invaginated into the cavity and successive sutures taken.
- Mesh - Used especially with large defects and tissue loss.
Retraction of External oblique, internal oblique, and transversus abdominis muscles laterally is done during which surgery? (AIIMS May 08)
- Laparoscopic kidney surgery approach
- Classical exposure of kidney
- Lumbotomy for renal cyst
- Spigelian hernia repair
Ans. D. Spigelian hernia repair