Abdominal wall surgery (incisional hernia)

Ventral hernia is a defect of the abdominal wall related to a previous surgical intervention. It occurs in approximately 10% of surgical abdominal incisions and become evident after a variable period following the surgery.

Predisposing conditions to incisional hernia are:

1. Surgical wound infection;
2. Sudden rises in intra-abdominal pressure: vomit, cough, exertion;
3. General diseases such as diabetes;
4. Inadequacy of the suture material and surgical technique errors;
5. Longitudinal wounds;
6. Enterostomies;
7. Advanced age;
8. Overweight and obesity.

Incisional hernia treatment has included two options for some years now. The traditional, i.e. open surgery, uses the scar itself as access route: the peritoneal bag is isolated along with incisional hernia gate, and the abdominal cavity’s peritoneal bag and its contents are reduced. The operation is completed with the placement of a prosthesis whose purpose is to reinforce the site where the pariteal failure has occurred. Generally, a drain tube is inserted to avoid the formation of annoying sieroma (subcutaneous serum deposits), which may in some cases unfortunately also become infected. The more recent, second option entails the use of laparoscopic mini-invasive surgery. To implement this technique, we must insert small cannulas through which lens, camera and surgical tools are entered.

This technique provides for the placement of a special prosthesis, consisting of two faces, one in contact with the abdominal wall, the other, smooth, in contact with bowel loops. The prosthesis is fastened with screw-shaped staples. One of the advantages offered by this technique is related to the mini-invasive surgery, which means less postoperative pain, faster feeding resumption, more rapid discharge, faster return to normal activities.