AboutProceduresReviewsInsuranceFormsContactCall 817.922.9229

Procedure Guide

Ventral / Incisional Hernia Repair

A ventral hernia occurs when tissue or organ pushes through a weakness in the abdominal wall. Incisional hernias are a specific type of ventral hernia that develops at the site of a prior surgical incision. Both may require surgical repair to prevent complications and restore abdominal wall integrity.

Occurs through the abdominal wallCommon after prior surgeryOpen, laparoscopic, or robotic repairMesh reinforcement often used
Schedule a ConsultationWarning Signs to Know
Medical illustration of ventral and incisional hernia repair showing abdominal wall defect and surgical mesh reinforcement

Quick Guide

Location

Anterior abdominal wall

Common Cause

Prior surgical incision or natural weakness

Approaches

Open, laparoscopic, or robotic

Mesh

Frequently used to reinforce repair

Patient-First Note

Ventral and incisional hernias vary widely in size and complexity. Some are small and straightforward to repair, while others involve significant abdominal wall reconstruction. Your evaluation will determine the best approach for your specific hernia.

What It Is

A defect in the abdominal wall

Ventral hernias develop when abdominal contents push through a weak point in the front of the abdomen. This creates a visible bulge that may increase with standing, straining, or lifting.

Incisional Hernias

Developing at a prior surgical site

Incisional hernias occur at or near a previous surgical incision where the abdominal wall did not heal completely. They are one of the most common complications of abdominal surgery, occurring in up to 20% of patients after open abdominal operations.

Risk Factors

Obesity, wound infection, and repeat surgery

Factors that increase the risk of ventral or incisional hernia include obesity, prior wound infection, diabetes, smoking, steroid use, and multiple prior abdominal surgeries.

Why Repair Matters

Hernias can enlarge and become complicated

Without repair, ventral hernias often grow over time. Larger hernias are more difficult to repair and carry a higher risk of incarceration (trapping of bowel) or strangulation (loss of blood supply).

Symptoms

What patients typically notice

The most common sign is a visible bulge in the abdomen that may increase with standing, coughing, or straining. The bulge may be reducible (can be pushed back in) or may become fixed over time.

Pain or discomfort at the hernia site is common, especially with activity. Some patients experience nausea, constipation, or a sense of abdominal pressure. Large hernias can affect posture, core strength, and daily function.

  • Bulge at or near a prior incision site
  • Pain or discomfort with activity or lifting
  • Bulge that enlarges over time
  • Difficulty with core strength or posture

Evaluation

How ventral hernias are assessed

Diagnosis typically involves a physical examination and CT scan of the abdomen. The CT scan helps determine the size of the defect, the contents of the hernia, and the quality of the surrounding abdominal wall — all of which guide the surgical plan.

For complex or recurrent hernias, additional planning may include assessment of muscle and fascial quality, evaluation of prior mesh if applicable, and discussion of whether abdominal wall reconstruction is needed.

How Care Is Planned

Treatment is based on your symptoms, exam, and the condition.

Laparoscopic / Robotic

Minimally invasive repair

For appropriately sized hernias, laparoscopic or robotic repair through small incisions offers less pain, shorter hospital stays, and lower wound complication rates. Mesh is typically placed to reinforce the repair.

Open Repair

For large or complex hernias

Large defects, recurrent hernias, or cases requiring abdominal wall reconstruction may need an open approach. This allows the surgeon to work directly with the tissue and place mesh in the optimal position.

Component Separation

Abdominal wall reconstruction

For very large or loss-of-domain hernias, advanced techniques like component separation release the abdominal wall muscles to allow tension-free closure. This is a specialized reconstruction performed by experienced surgeons.

Recovery Timeline

What recovery may look like.

Step 1

Before surgery

CT imaging and physical examination determine the hernia size and complexity. Weight optimization, smoking cessation, and diabetes control may be recommended before elective repair to improve outcomes.

Step 2

Procedure day

Surgery duration varies from one to several hours depending on hernia size and complexity. Laparoscopic repairs may allow same-day or next-day discharge. Open repairs typically require two to four days in the hospital.

Step 3

Early recovery

An abdominal binder is often worn for support. Activity is gradually increased. No heavy lifting over 20 lbs for 6 weeks following surgery.

Step 4

Full recovery

Most patients return to normal activity within four to eight weeks. Complex reconstructions may require a longer recovery period. Core strength gradually returns over several months.

Common Questions

Answers patients often want before scheduling.

What is the difference between a ventral and incisional hernia?

A ventral hernia is any hernia through the front of the abdominal wall. An incisional hernia is a specific type of ventral hernia that occurs at the site of a previous surgical incision. The treatment approach is similar for both.

Will mesh be used in my repair?

Mesh is used in the majority of ventral and incisional hernia repairs because it significantly reduces the risk of recurrence compared to suture-only repair. The type and placement of mesh depends on the hernia and surgical approach.

Can a ventral hernia come back after repair?

Recurrence is possible, particularly with large hernias or in patients with risk factors like obesity or diabetes. Mesh reinforcement, proper surgical technique, and post-operative precautions all help minimize this risk.

How do I know if my hernia needs surgery?

Not all hernias require immediate repair. Surgery is recommended when the hernia causes pain, limits activity, is enlarging, or shows signs of potential complications like incarceration. Your surgeon will help determine the right timing.

Consultation

Talk through your symptoms and next steps.

Call our office to schedule an evaluation with Dr. Bayouth. This page is educational and should not replace personal medical advice.

Call 817.922.9229Return to Home