A ventral hernia occurs when there is a weakness of the abdominal wall muscles, usually following a previous operation. The edges of the muscle become separated over a period of time, allowing the internal organs to bulge out. if the opening is small, the hernia can become "incarcerated", or stuck. This can be a very serious emergency. If the hernia is large, it can be very uncomfortable. all hernias tend to grow larger as time goes by. In general, if a ventral (or "incisional") hernia is causing symptoms, or becoming larger, it should be fixed to prevent these complications.

Repairing a ventral hernia requires a reconstruction of the abdominal wall. In most cases, just sewing it together again will not work. It has been found that placing one or two layers of plastic mesh over the defect in the muscles, and sewing the edges of the mesh to the edges of the defect, can provide a long-lasting repair of the problem. Even with this technique, hernias can come back.

The risk factors which increase the chances of hernias coming back are: overweight, smoking, age, and certain medications. Smoking and overweight are certainly the biggest problems, and the easiest to do something about. Before having the hernia fixed, smoking should be discontinued, and a program of weight loss planned, if necessary. This will decrease the chance of hernia recurrence.

THE OPERATION
Most ventral hernia repairs require a few days in the hospital. Smaller hernias may be repaired as an outpatient. If the hernia is large, and there is intestine caught in it, it may be necessary to take laxatives and antibiotics on the day before the operation in order to clean out the intestine.

The repair is usually done under general anesthesia, on the day you come to the hospital. Depending on the size of the hernia, the operation may take from one to three hours. If the hernia is very large, and the intestine is involved, it may be necessary to place a nasogastric tube and a urinary catheter to keep the stomach and bladder empty during the operation.