Understanding the different types of and treatment options for abdominal hernias.

There are many different types of abdominal hernias that can occur. The most common abdominal hernias include:

  • Ventral hernia
  • Umbilical hernia
  • Incisional hernia

Common causes for abdominal hernias include:

  • Weight loss
  • Pregnancy
  • Prior abdominal surgery
  • Congenital (born with it)

Ventral Hernia

A ventral hernia is a hernia that occurs in the middle of the abdomen vertically between the rectus abdominus muscles (six pack muscles). The best way to imagine and understand this type of hernia is to envision a long, skinny football shaped weakness oriented vertically (up and down) in the middle of the abdominal wall.

A ventral hernia can be caused by any of the above sources that been listed, but the two most common is pregnancy and prior abdominal surgery. Often, weight gain and weight loss in addition to either surgery or pregnancy also is a factor.

Repair of a ventral hernia can be performed by suturing the muscles back together, or by using some sort of mesh. I prefer to bring the healthy tissues back together as this is truly the only real hernia repair that allows the patient to regain their core strength. Sometimes a ventral hernia can be more subtle, without a definite border to where the hernia starts and stops. This is seen more often after pregnancy and is often called rectus diastasis. Repair of correction of ventral hernia and rectus diastasis is often similar in terms of bringing together the healthy tissue layers. When the hernia is too big to do so, component separation, where the muscle layers are separated, can be performed and/or the use of acellular dermal matrix can be used to reinforce the repair.

Umbilical Hernia

 An umbilical hernia is a hernia or weakness of the abdominal wall near the belly button. This is one of the most common types of hernias to be born with and one of the most common types of hernias to develop as a result of weight gain or pregnancy. Umbilical hernias are commonly referred to as an “outie belly button”.

General surgeons typically like to use mesh plugs to repair the hernias while Plastic Surgeons usually like to repair the hernias but bringing together the healthy borders of the surrounding tissue. An umbilical hernia can be repaired via a small incision around the border of the belly button or via a larger incision if a ventral hernia or a tummy tuck is being performed at the same time.

Incisional Hernia

An incisional hernia is a weakness or separation of tissues where there has been a previous incision made. Many abdominal surgeries can result in an incisional hernia. Fortunately, most abdominal surgeries are now performed laparoscopically with small incisions.   Occasionally, and abdominal surgery to remove an infected gallbladder or appendix or to treat problems with the liver, pancreas, or colon is needed. When these types of large incisions are used there is a risk that the tissues will either thin out at the incision site or the incision site tissue pull partially apart. Repair of these incisional hernias usually proceed by using the existing incision and bringing together the healthy borders of the tissue. Incisional hernias are often the type of hernias that can benefit most from the use of mesh or acellular dermal matrix.

I hope this introduction of abdominal hernias helps educate those that are struggling with hernias and wondering how to best go about finding help.

All the best,
Dr. Remus Repta

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