Ventral hernias almost always require surgical repair. Although some individuals manage their symptoms with adjustments to their diet, health, and lifestyle, ventral hernias are progressive. Without proper treatment, they eventually become worse. Surgery is required for ventral hernias to prevent complications and life loss.
To better understand the treatment options available at Orange County Robotic General, continue reading this guide on the most common types of ventral hernias
- What is a ventral hernia?
- The 5 different types of ventral hernias
- How is a ventral hernia diagnosed?
- What are the signs and symptoms of a ventral hernia?
- What are the causes and risk factors for developing a ventral hernia?
- Repairing ventral hernias
What Is a Ventral Hernia?
Ventral hernias are usually present at birth but can also develop over time from various lifestyle and health issues. The abdominal cavity houses several organs, including the intestines. When the abdominal fascia in the muscular wall becomes weak, fatty tissue, a portion of an organ, or the intestines push through, creating a visible bulge. This bulge is known as a ventral hernia, and the pain and discomfort it causes come from the tissues squeezing and swelling through the opening.
Hernias, especially those that occur in the belly, are very common. Although the most common place for them to develop is in and near the navel area and anywhere in the abdominal cavity. Ventral hernias usually cause mild symptoms that come and go.
The 5 Different Types of Ventral Hernias
Ventral hernias are classified according to their location. As such, there are five types of ventral hernias: epigastric, umbilical, periumbilical, lateral, and incisional.
Epigastric ventral hernias develop between the navel and below the chest area (breastbone) on the centerline. Epigastric ventral hernias are also referred to as stomach or abdominal hernias.
Umbilical ventral hernias are located in the navel area and are most commonly diagnosed in babies and children. Many adults also develop umbilical ventral hernias, although the condition is less common during adulthood. Childhood umbilical ventral hernias usually resolve without surgical intervention. However, adults who develop the condition require surgery to repair the defect to alleviate pain, nausea, pressure, and discomfort.
Periumbilical ventral hernias are similar to umbilical hernias, but they occur above the belly button. This type of ventral hernia is commonly seen in older adults and overweight individuals. Periumbilical ventral hernias can be difficult to manage without surgical repair. Symptoms include dull aches and sharp pain and swelling of the hernia.
Lateral ventral hernias are also called Spigelian hernias. This type of hernia is very rare and more common in women. Lateral ventral hernias develop on either side of the abdominal wall and are often present at birth. Spigelian hernias can also develop later in life due to medical, health, and other factors.
Incisional ventral hernias are common in patients with a history of stomach or abdominal surgeries. The incision sites have scar tissue and are weaker than the other areas of the abdominal wall. Over time, these areas become vulnerable to pressure and strain and may become further compromised by injury, trauma, or old age. Eventually they become too weak to keep the abdominal tissue and organs in place. As this area grows weaker, the organs or abdominal tissue bulge through.
How Is a Ventral Hernia Diagnosed?
Doctors rely on the patient’s reported symptoms, concerns, medical history, physical examination, and diagnostics to identify the presence, location, and severity of a ventral hernia. It’s common for patients to complain of stomach or epigastric/breastbone pain, vomiting, nausea, and swelling or bulging.
A physical examination of the abdomen and or epigastric area can reveal significant swelling that may be tender with palpation, but not always. To confirm the diagnosis, additional tests, such as ultrasound, CT scan, blood tests, and a urinalysis, may be ordered.
What Are the Signs and Symptoms of a Ventral Hernia?
Ventral hernia symptoms vary depending on location. During the early stages, the hernia may bulge and swell only to become smaller and less noticeable with movement or when pushed. As the condition progresses, symptoms begin to occur, causing significant discomfort intermittently or chronically. Symptoms can flare when using the bathroom, lifting, twisting, eating, or standing in place for extended periods of time.
Symptoms of a ventral hernia include the following:
- Dull or aching pain
- A bulge that may be red or tender
Ventral hernias are serious and can become medical emergencies if incarceration or strangulation occurs. If you experience sudden, sharp pain that persists or notice that your abdominal hernia is red or painful to touch and are nauseous or vomiting, head to your nearest emergency room immediately. These are signs of possible life-threatening complications, including bowel obstruction or strangulation and emergency hernia repair surgery is necessary.
What Are the Causes and Risk Factors for Developing a Ventral Hernia?
Hernias are more common with age, but certain health and medical conditions and activities can increase the likelihood of hernia development. The most common cause of ventral hernia is abdominal weakness.
- Abominable injury or trauma
- Old incisions
- Heavy lifting
- Chronic coughing
- Forceful vomiting
- Straining during bowel movements
- Congenital defects
- COPD (chronic obstructive pulmonary disease)
There is no way to know for sure who will develop a ventral hernia. However, individuals with the above risk factors are more likely to experience the condition at some point during their lives.
Repairing Ventral Hernias
Ventral hernias are correctable with surgery. Surgery is necessary to reposition the bulging tissues and organs back into place so the surgeon can seal and reinforce the gap. Depending on the severity of the condition, this may be done by suturing the fascia tissue together or installing a mesh.
Ventral hernia repair surgery can be done laparoscopically, robotic assisted, and as an open procedure. Laparoscopic and robotic ventral hernia repair surgeries utilize several tiny incisions and are minimally invasive. These options are the standard in modern hernia repair. Patients recover faster and have less pain and better outcomes.
Open ventral hernia repair surgery is done through a single, large incision. Open hernia repair is reserved for patients with complicated or advanced hernias and those who are not good candidates for minimally invasive treatment due to health and other factors.
Both laparoscopic and robotic-assisted ventral hernia repair surgeries are well tolerated by patients. The advantages of minimally invasive treatment to conventional hernia repair are:
- Smaller incisions
- Less scar tissues
- Lower risk of infections and complications
- Less pain
- Shorter hospital stays
- Quicker healing and recovery
- Faster return to normal activities
- Fewer post-surgical restrictions
Minimally invasive hernia repair is not for everyone. In rare cases, laparoscopic or robotic-assisted hernia surgery may be converted to an open operation. Dr. Abtin Khosravi, MD, only makes this change when necessary. All treatment and surgical considerations are based on what’s safest for the patient.
Ventral hernias are common and affect both men and women. Besides an examination, diagnostic tests are performed to diagnose and determine the most suitable treatment. Timely treatment is beneficial to prevent severe discomfort, complications, and life-threatening emergencies.
Patients may benefit from laparoscopic, robotic-assist, or open hernia surgery. Treatment depends on the patient and the hernia specialist’s professional recommendations.
If you believe you have a ventral hernia or experience hernia symptoms, it’s important to see a hernia specialist for treatment to prevent further issues. Contact Orange County Robotic General Surgery at (714) 541-4996 for an appointment with Dr. Abtin Khosravi, MD, hernia repair specialist extraordinaire.
To find out if inguinal hernia repair surgery is right for you, Contact Orange County General Robotic Surgery at (714) 706-1257 for a consultation with Dr. Abtin H. Khosravi.