Ventral Hernias: Risk Factors and Symptoms
One of the most common types of hernias occurs when a person’s intestines push through a weak area of the abdominal wall muscles. This type of hernia is called a “ventral hernia.” A recent study indicated that patients undergoing abdominal surgery are at an increased risk for ventral hernias due to the weakening of the abdominal muscles at the site of the surgical scar. However, there are several risk factors that can make a person more susceptible to a ventral hernia.
Risk factors include:
- Prior abdominal surgeries
- Inujuries and trauma to the abdomen
- Lifting or pushing heavy objects
- Genetic predisposition for ventral hernias
Symptoms of a ventral hernia can range from severe pain and discomfort to no symptoms at all. Typically, patients notice a bulge or an area that is tender. Doctors often make a diagnosis after observing the area in question and ordering tests such as CT scans, ultrasound studies, and MRIs.
Common symptoms experienced:
- Pain in the abdomen
- Bulging in a specific area of the abdomen that often worsens with certain movements
- Nausea and vomiting
Untreated Ventral Hernias Cause Serious Injuries
Ventral hernias should be treated as soon as they are discovered because as the hernia grows it can become more difficult treat. Some of the most dangerous complications of a hernia are entrapment (strangulation) of the contents of the hernia. For example, a ventral hernia containing a patient's bowels can lead to a serious situation where the bowel loses blood supply and dies due to becoming entrapped. This situation often requires immediate surgical repair. In other extreme cases, intestines can become incarcerated. In this scenario, the intestines become trapped outside of the abdomen and often lose vital blood supply.
Hernias that have grown over 10 centimeters are considered “giant ventricular hernias,” They often grow so large that they can make separating the herniated tissue from the surrounding abdominal organs extremely difficult. In addition, once a hernia grows to such a large size, the risk of recurrence dramatically increases.
Treatment Options For Ventral Hernias
There are a few options for hernia treatment depending on the size and location. These treatment options include:
- Minimally invasive laparoscopic surgery to remove and repair the hernia via small incisions in the patient's abdomen;
- Laparotomy (open surgery) repair by making a large incision, pushing the tissue back into its proper location, and sewing the incision closed; or
- Mesh placement surgery requiring the surgeon to sew in a mesh “patch” over the area in which the surgeon pushed the patient's tissues back into their proper locations.
Problems With Surgical Mesh Used to Repair Hernias
Patients that have undergone hernia repair surgery in which a polypropylene mesh patch was implanted are reporting serious complications. These complications include pain, abdominal adhesions, bacterial infections, inflammation, intestinal obstruction, and even recurrence of their hernia. In most situations, additional surgeries are necessary to remove the implanted mesh and any damage it has caused internally.
Some of the most notable mesh products under investigation are Physiomesh, manufactured by a division of Johnson & Johnson, and Atrium's C-QUR hernia mesh. Due to overwhelming evidence of issues and a high failure rate, Johnson & Johnson's Physiomesh was recalled in May 2016.