Ventral Hernia
Overview
Hernias most commonly develop in the abdominal wall, where an area weakens and develops a tear or hole. Abdominal tissue or part of the intestines may push through this weakened area, causing pain and potentially serious complications.
Ventral hernias are a type of abdominal hernia. They may develop as a defect at birth, resulting from incomplete closure of part of the abdominal wall, or develop where an incision was made during an abdominal surgery, occurring when the incision doesn't heal properly.
Incisional hernias can develop soon after surgery or many years later. They affect as many as 30 percent of the patients who have abdominal surgery, such as an appendectomy.
Our approach to ventral hernia
UCSF offers state-of-the-art surgical repair and rehabilitation for all types of hernias, including ventral hernias. Our surgeons perform a large number of hernia repairs and are known for accepting complex, technically challenging cases. Despite this, our patient outcomes are notably better than the national average. Less than 20 percent of our ventral hernia patients have a recurrence, compared to a national average of 30 to 40 percent.
Whenever possible, we use minimally invasive approaches to hernia repair. Compared with traditional open surgery, minimally invasive surgery has significant benefits for patients, including a faster recovery, lower risk of infection, and less pain and scarring.
The treatment team includes gastrointestinal surgeons, plastic and reconstructive surgeons, wound care specialists, intensive care specialists, anesthesiologists and experts in nutritional and physical rehabilitation. In addition to caring for patients, our surgeons lead innovative research aimed at refining surgical techniques and improving the materials used in hernia repair.
Awards & recognition
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Among the top hospitals in the nation
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One of the nation's best for gastroenterology & GI surgery
Signs & symptoms
Ventral hernias cause a bulge or lump in the abdomen, which increases in size over time. In some cases, the lump may disappear when you lie down, and then reappear or enlarge when you put pressure on your abdomen, such as when you stand, or lift or push something heavy.
When tissue inside the hernia becomes stuck or trapped in abdominal muscle, it can cause pain, nausea, vomiting and constipation.
In rare cases, this may lead to a potentially life-threatening condition known as "strangulation," which requires emergency surgery. This occurs when the blood supply to the herniated bowel is cut off or greatly reduced, causing the bowel tissue to die or rupture. Other symptoms of a strangulated hernia include severe abdominal pain, profuse sweating, rapid heartbeat, severe nausea, vomiting and high fever.
Diagnosis
In many cases, a hernia can be diagnosed through a physical examination of the abdomen.
Your doctor will examine the area where a ventral hernia may exist and may ask you to cough while examining your abdomen.
A CT scan may be performed as part of the diagnosis.
Treatments
Ventral hernias are repaired by surgery. Without treatment, most hernias will increase in size.
An untreated hernia may also result in intestinal blockage and "strangulation," which requires immediate medical attention. Strangulation occurs when the blood supply to the herniated bowel is cut off or greatly reduced, causing the bowel tissue to die or rupture.
Surgical repair of ventral hernias is a complicated, major procedure. Extremely large ventral hernias require a procedure called progressive pneumoperitoneum.
Laparoscopic repair
In this approach, surgeons use a laparoscope, a tiny telescope with a television camera attached, to view the hernia from the inside. The laparoscope is placed inside a cannula, or small, hollow tube, which is inserted into the abdomen through a small incision.
In most cases, three or four incisions of about 1/4 to 1/2 inch in size are made to insert the cannula, instruments used to remove any scar tissue and a special mesh. The mesh is placed behind the abdominal muscles instead of between the muscles. It is held in place by surgical tacks or sutures.
This procedure is usually performed under general anesthesia. Bladder catheterization is required.
Compared to traditional hernia surgery, laparoscopic repair includes less post-surgery pain, less wound numbness and an earlier return to work and normal activities.
We can perform certain hernia repairs using robotic surgery, another minimally invasive technique with similar benefits.
At UCSF Medical Center, ventral hernias are treated by specialists in the Complex Abdominal Surgery Program.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
