While many are very straight forward, incisional hernias can be the most complex and challenging type of hernia to treat. Incisional hernias are created from previous abdominal operations, in which the closure of the fascial layer does not heal properly. When this occurs, it leaves a hole or defect in the muscular abdominal wall allowing intraabdominal contents to herniate through.
What is an Incisional Hernia?
An incisional hernia is precisely that. It is a hernia that has occurred from a previous incision. When incisions are made, the muscle and/or fascia is violated. Although it is sutured back together, post-operative forces may tear the suture or tissue thereby creating a hole, or hernia, in the abdominal wall. The size of incisional hernias can vary greatly depending on many factors. Obesity, diabetes, smoking and wound infections increase the likelihood of having an incisional hernia.
While physical exam and history are typically all that is required to diagnose an incisional hernia, a CT scan is often necessary to assess the remainder of the abdominal wall. It is also helpful for operative planning. A CT scan may find additional hernias not found on examination. It may also find other consequences from previous abdominal operations like atrophy of muscles. It may also be necessary in order to assess whether a more extensive operation such as a component separation may be needed.
Benefits of robotic repair
The vast majority of incisional hernias are repaired minimally invasively using the robotic technique. Doing this, we are able to perform complex reconstructions through only 3 small incisions. This dramatically reduces your chance for wound complications as well as the need for a prolonged hospital stay.
While mesh complications are uncommon, the majority of them are related to intraperitoneal mesh, meaning mesh placed inside the abdominal cavity adjacent to mobile intestine. 99% of the time, Dr. Glover is able to repair hernias with mesh protected by your own tissues. Dr. Glover was the first in central Texas in 2016 to employ the eTEP technique which allows for a retro-muscular repair through 3 incisions, which previously required 6 incisions or an open procedure.
Abdominal core health quality collaborative
It is often said that no surgeon truly knows his own hernia recurrence rate. How do you know what you are doing is working if you’re not keeping track?
The Americas Hernia Society aims to fix just that with the Abdominal Core Health Quality Collaborative or ACHQC. The quality collaborative is a database created by hernia surgeons that enables them to keep track of their performance, patient outcomes and complications. It also allows us to come together to pool our data to add significance and meaning to the numbers.
It is not research and nothing we do is experimental. It is merely a tool to make good surgeons better.
Participating in the ACHQC is completely optional with no obligation. There is no requirement to participate in order to have your hernia repaired.