A condition where a part of the abdominal contents such as the bowel or intestines, protrude through a weakened part of the abdominal wall. Weakness in the abdominal wall can result from heavy lifting, chronic coughing, severe vomiting, obesity, pregnancy and diabetes. If the protruding loop of intestine or bowel becomes trapped tightly enough to cut of circulation, immediate medical attention is necessary as the condition is very serious. If the hernia occurs where an old surgical scar was then it is called an incisional hernia.
- Lump in abdomen (may be able to be pushed back in (reducible hernia) or may be stuck (irreducible)
- Pain in abdomen
- Pain and tenderness over lump
- Abdominal distension
Sometimes known as a lateral ventral hernia, a spigelian hernia is a type of hernia that develops through the spigelian fascia. Unlike many hernias that thrive just below layers of fat, a spigelian hernia occurs in between the muscles found in the abdominal wall. Because of the nature of this type of hernia, there is often little outward evidence of swelling, making it possible for the health issue to go undetected for longer periods of time.
Often beginning somewhere along the linea simularis, a line of tissue situated on each side the rectus abdominis, the causes for a spigelian hernia are similar to the health issues that lead to most other types of hernias. The condition may develop due to a weakening of the abdominal wall later in life, injury, or prolonged periods of physical stress. Men and women tend to exhibit an equal opportunity to experience a health condition of the nature. Unlike other hernias, a spigelian hernia can often be mistaken for some other type of abdominal problem.
Three are a few symptoms that may indicate the presence of a spigelian hernia. Recurring pain in the immediate area, following by a period of constant dull pain is a common indicator. A sudden decrease in the proper function of the bowels, especially one that lasts for more than a day or two, is also a strong sign. While the protrusion may be very small, it may be visible in people with relatively little fat in the abdominal area and will tend to be soft to the touch.
The most common treatment for a spigelian hernia is to undergo surgery to repair the damage caused. Depending on the severity of the damage, the surgeon may utilize some type of mesh to reinforce the weakened abdominal wall and thus decrease the opportunity for a recurrence.
It is important to note that a hernia of this type can cause a great deal of damage if left untreated. The spigelian hernia may develop in a location where the bowels are in effect strangulated, or cause some type of obstruction in the colon. Both these situations can lead to the deterioration of both organs and eventually cause complete failure.
Fortunately, a spigelian hernia is a relatively rare occurrence. In most instances, the condition does not develop before the age of 40 and is more likely to occur after the age of 50. The hernia is also more likely to develop on the right side of the abdomen rather than the left.
A parastomal hernia is the protrusion of intestine through abdominal muscles around the stoma, and is seen as a bulge under the skin around the stoma. A parastomal hernia can occur reasonably frequently, as the muscles around the stoma have been 'surgically weakened.' These muscles which normally provide support are deliberately incised open to allow the formation of the stoma, hence they are often weaker. The hernia may sometimes be supported with a wide belt or binder and sometimes needs surgical correction if it has progressed too far and is causing issues.
Prevention is Better Than Cure
Everyone should take care to protect their abdomen. But the surgery required to make a stoma can weaken muscles so it pays to be extra careful when doing any form of lifting or exercise.
With a stoma, the risk of hernia from lifting or strenuous exercise is generally higher than that of developing a common groin hernia because the muscles supporting the stoma are not as strong as they were before surgery, because they were cut apart to make the stoma.
Some preventive measures to guard against the development of a stoma hernia include:
- Gentle abdominal exercises such as sit-ups and walking
- Avoid heavy lifting and straining. If necessary, use a wheeled trolley to help move heavier items or get someone to help you
- Weight management - stay within an appropriate weight range
Ventral or abdominal hernias occur when the intestine pushes through a weakening in the abdominal wall. They are frequently referred to as incisional hernias because the bulge often occurs at the site of a previous surgical incision.
Any one of these hernias may be recurrent. This means, simply, that a previously repaired hernia has returned. People with especially weak abdominal walls or multiple surgical sites may simultaneously suffer from a combination of types of hernias.
Bard® Composix® Kugel® Patch Technique
The Bard Composix Kugel patch is specifically designed for use in open ventral hernia repair because it eliminates the tension and strain on surrounding muscles and ligaments, and therefore reduces discomfort after surgery. This patch can be inserted through a relatively small incision and is designed it to lie flat against the abdominal wall and requires fewer sutures. This mesh helps healthy tissue grow and provides a strong, permanent repair.
This procedure takes an average of 1 to 2 hours to complete, and requires general anesthesia. Like any surgery, there is always a chance for complications, like infection or hernia recurrence. Your physician will discuss these with you prior to surgery.
Bard® Composix® E/X and L/P Mesh Technique
Bard Composix E/X and L/P Mesh allow for a strong repair of the abdominal wall and is specifically designed for use in laparoscopic ventral hernia repair. This repair is done with only two to four separate incisions (approximately one cm each) in the abdomen. The mesh will be pulled through one of the small punctures and fixated in place to cover the hernia defect and reinforce the weak tissue around the hernia.
On average, this minimally invasive procedure takes between one to two hours to complete. General anesthesia is required for laparoscopic hernia surgery. Like any surgery, there is always a chance for complications, like infection or hernia recurrence. Your physician will discuss these with you prior to surgery.
Operative video of a laparoscopic repair of a suprapubic hernia that occurred after hysterectomy >
Operative video of a post hysterectomy incisional hernia in the suprapubic position >