> Disorders > Pathologic Function > Incisional Hernia

Incisional Hernia

Q: What are the common causes of an incisional hernia?

Incisional hernias typically develop at the site of a previous surgical incision, such as those made during appendectomies, hysterectomies, or colon resections. The weakening of the abdominal wall during the healing process after surgery can allow internal organs or tissues to push through, leading to the formation of an incisional hernia.

Q: What are the potential complications of an untreated incisional hernia?

If left untreated, an incisional hernia can cause significant pain, discomfort, and potentially serious complications. Untreated hernias can lead to the entrapment or strangulation of internal organs, which can cut off blood supply and cause tissue damage. This can result in life-threatening complications that require emergency surgery.

Q: How can PubCompare.ai help with incisional hernia research?

PubComapre.ai allows researchers to more efficiently screen protocol literature and leverage AI to pinpoint critical insights. The platform can help identify the most effective protocols related to incisional hernia repair, highlighting key differences in protocol effectiveness. This enables researchers to choose the best option for reproducibility and accuracy, streamlining their studies and making more informed decisions.

Q: What are the different types of incisional hernia?

There are several variations of incisional hernias, including direct, indirect, and mixed types. Direct incisional hernias occur directly at the site of the surgical incision, while indirect hernias develop nearby but separate from the incision. Mixed hernias involve both direct and indirect components. Understanfing the specific type of incisional hernia is important for determining the most appropriate surgical approach and treatment plan.

Q: How can PubCompare.ai enhance the reproducibility of incisional hernia studies?

PubCompare.ai's AI-driven analysis tools can help researchers identify the key differences in protocol effectiveness for incisional hernia repair. By highlighting the critical factors that contribute to successful outcomes, the platform enables researchers to choose the most reproducible protocols. This enhances the reliability and accuracy of their findings, ultimately improving patient care and reducing the risk of recurrence.

Incisional hernia is a type of abdominal wall defect that occurs at the site of a previous surgical incision.
It can develop after any type of abdominal surgery, such as appendectomy, hysterectomy, or colon resection.
Incisional hernias can cause pain, discomfort, and potentially serious complications if left untreated.
Effective management often requires surgical repair to restore the integrity of the abdominal wall and prevent further complications.
Understanding the optimal surgical protocols for incisional hernia repair is crucial for improving patient outcomes and reducing the risk of recurrence.
Pubcompare.ai's AI-driven tools can help researchers streamline their incisional hernia studies, locate the best protocols from literature, preprints, and patents, and enhance the reproducibility of their findings.

Most cited protocols related to «Incisional Hernia»

Incisional Hernia Classification Proposals

Cited 41 times

Chevrel and Rath [3 (link)] proposed a classification for incisional hernias in 2000. This classification is attractive, because it is simple, and the data required to reach the classification are readily obtained. Three parameters were utilised. Firstly, the localisation of the hernia of the abdominal wall: divided into median (M1–M4) and lateral (L1–L4) hernias. Secondly, the size of the hernia: it was postulated that the width of the hernia defect is the most important parameter (greater than hernia defect surface, length of the hernia or size of the hernia sac), which was divided into four groups (W1–W4). As a third parameter of this classification, subgroups were made for incisional hernias and recurrences: the number of previous hernia repairs was recorded as (R0, R1, R2, R3,…). Although apparently easy to use, this classification has not been commonly used in the literature.
In his book on hernia surgery, “Hernien”, Schumpelick described a classification that divided incisional hernias into five classes [2 ]. The size of the defect, the clinical aspect of the hernia in lying and standing position, the localisation of the incision and the number of previous repairs were used for this classification.
Korenkov et al. [4 (link)] reported on the results of an expert meeting on classification and surgical treatment of incisional hernia, but no detailed classification proposal resulted from this meeting.
Ammaturo and Bassi [6 (link)] suggested an additional parameter to the Chevrel classification. The ratio between the anterior abdominal wall surface and the wall defect surface predicts a strong abdominal wall tension when closing the defect, with possible abdominal compartment syndrome development, and thus might influence the choice of surgical technique.
Recently, Dietz et al. [5 (link)] proposed another alternative classification of incisional hernias in which variables like body type, hernia morphology and risk factors for recurrence were included and recommendations made for surgical repair based on the different types. It is based on a self-explanatory taxonomy and is intended to tailor the repair to the body type and risk factors of the individual patient.
The Swedish Abdominal Wall Hernia Registry presented their data collection sheet for incisional and ventral hernias at the EAES congress in Stockholm in June 2008, which forms the basis for a classification and includes many prognostic relevant variables. For this reason Agneta Montgomery was invited to the consensus meeting to present the method of classification used in Sweden.

Muysoms F.E., Miserez M., Berrevoet F., Campanelli G., Champault G.G., Chelala E., Dietz U.A., Eker H.H., El Nakadi I., Hauters P., Hidalgo Pascual M., Hoeferlin A., Klinge U., Montgomery A., Simmermacher R.K., Simons M.P., Śmietański M., Sommeling C., Tollens T., Vierendeels T, & Kingsnorth A. (2009). Classification of primary and incisional abdominal wall hernias. Hernia, 13(4), 407-414.

Publication 2009

Abdominal Compartment Syndrome Experimental Autoimmune Encephalomyelitis Hernia Hernia, Abdominal Herniorrhaphy Incisional Hernia Operative Surgical Procedures Patients Recurrence Somatotype Ventral Hernia Wall, Abdominal Wound Healing

Classification of Abdominal Wall Hernias

Cited 9 times

When proposing a classification, it is important to determine the most suitable variables to include in the classification. However, it is important to keep a classification simple and practical to use. In Table 1 the potential variables are listed, as well as their use in previously proposed classifications. It is impossible to take all these variables into account for a practical classification, so a decision on inclusion or exclusion of various parameters was made.Table 1

Possible variables to use for classifying primary and incisional abdominal wall hernias and their use in previous classifications

Variables for classification of primary or incisional abdominal wall hernias	Chevrel and Rath [3 (link)]	Korenkov et al. [4 (link)]	Schumpelick[2 ]	Ammaturo and Bassi [6 (link)]	Swedish registry	Dietz et al. [5 (link)]
Size of the hernia defect: surface area, length, width	Width	Width or length	Maximal size	Width	Width and length	Width and length
Size of the hernia sac
Number of hernia defects			×		×
BMI of the patient					×	×
Ratio anterior abdominal wall surface/wall defect surface				×
Ratio between the abdominal volume/the volume of the hernia sac
Primary versus incisional hernias
Recurrent hernias (number of previous repairs)	×	×	×	×	×	×
Previous mesh implantation					×
Indication for the operation causing the incisional hernia					×
Type and localisation of the incision					×
Symptoms of the hernia		×
Reducibility of the hernia		×	×		×
Localisation of the hernia	×	×	×	×	×	×
The anatomy of the patient in the subcostal area: sternocostal angle						×
Other risk factors for hernia recurrence						×

Publication 2009

Abdomen Hernia Hernia, Abdominal Incisional Hernia Ovum Implantation Patients Recurrence Surgical Mesh Wall, Abdominal Wound Healing

Anubifix™ Embalming and Laparoscopic Exploration

Cited 4 times

An anatomic specimen embalmed by means of the Anubifix^™ method was used. This embalming technique is based on a new prerinsing method combined with a normal 4% formaldehyde fixation solution. In contrast to conventional embalming methods, Anubifix^™ embalming results in a very small decrease in flexibility and plasticity. Furthermore, this result is accomplished without impairing the quality and duration of conservation. Anubifix^™ embalming results in a preserved range of motion of joints and flexibility of the abdominal wall combined with tissue tactility comparable to fresh-frozen tissues, this all in contrast to conventional embalming methods.
After the embalming phase, a midline laparotomy of 20 cm was performed. The specific aspects of the colorectal anatomy were dissected and marked [aorta and iliac arteries (dark red), superior mesenteric artery/vein and its branches (red/blue), inferior mesenteric artery/vein and its branches (red/blue), gonadal arteries (purple), and ureters (yellow)]. Coloring of the vessels and ureters was performed circumferentially with a specially developed formaldehyde-proof paint (FPP^™). After dissection and coloring, the abdominal muscle wall was separated from the overlying fat and skin and closed with running sutures. A rectangular sheet of synthetic butyl rubber measuring 26 × 6 cm with a circular hole at the level of the umbilicus was sutured on top of the sutured muscle wall, analogous to an onlay mesh for incisional hernia, after which the skin was closed with running sutures. The use of a butyl rubber sheet results in an airtight closure of the abdominal wall permitting the creation of a pneumoperitoneum despite the prior abdominal opening. A 10-mm trocar was placed at the umbilicus through which a 30º scope was placed. A standard set of laparoscopic instruments was used. Four 5-mm trocars were placed in the right and left upper quadrants. Pneumoperitoneum was achieved with a continuous flow of CO₂, with the pressure set between 12 and 15 mmHg, i.e., comparable to the in vivo situation.

Slieker J.C., Theeuwes H.P., van Rooijen G.L., Lange J.F, & Kleinrensink G.J. (2012). Training in laparoscopic colorectal surgery: a new educational model using specially embalmed human anatomical specimen. Surgical Endoscopy, 26(8), 2189-2194.

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Publication 2012

Abdomen Aorta Arteries Blood Vessel butyl rubber Dental Inlays Dissection Formaldehyde Formalin Freezing Gonads Iliac Artery Incisional Hernia Laparoscopy Laparotomy Mesenteric Arteries, Inferior Muscle Tissue Pneumoperitoneum Pressure Range of Motion, Articular Skin Superior Mesenteric Arteries Sutures Tissues Trocar Umbilicus Ureter Veins Wall, Abdominal

Predictive Factors for Incisional Hernia in Colorectal Cancer

Cited 3 times

Protocol full text hidden due to copyright restrictions

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Publication 2016

Abdomen BLOOD Chemotherapy, Adjuvant Colorectal Carcinoma Diabetes Mellitus Ethics Committees, Research Faculty Gender Hernia Incisional Hernia Malignant Neoplasms Ovum Implantation Patients Recurrence Sodium Chloride, Dietary Surgical Mesh Transplantation Youth

Classifying Abdominal Wall Hernias

Cited 3 times

The first decision to take was whether the classification would involve primary ventral hernias and incisional ventral hernias in one classification or if two separate classifications were preferable. A consensus was reached on the decision to separate the two entities, since in the authors’ opinion primary ventral hernias have a different aetiopathology compared with incisional abdominal wall hernias resulting from failure of a previous incision. The group reached agreement on separating non-incisional hernias, “primary abdominal wall hernias” (also known as “ventral”). and the other “incisional abdominal wall hernias”. A recurrent hernia after a primary abdominal wall hernia treatment will then fall into the incisional hernia group. To avoid confusion, the word “primary incisional hernia” should not be used.
There was a consensus to exclude “parastomal hernias” from this classification. Although they are by definition incisional hernias, they make up a distinct group, with specific properties and treatment options.

Publication 2009

Hernia Hernia, Abdominal Incisional Hernia Ventral Hernia

Most recents protocols related to «Incisional Hernia»

Incisional Hernia Risk Factors: Multivariate Analysis

SPSS 28 was used to manage and analyze data (IBM, Armonk, New York, United States). Quantitative data normality was determined using Kolmogorov–Smirnov, Shapiro–Wilk, and direct data visualization. Categorical data are presented with numbers and percentages. Quantitative and qualitative data were compared using the Chi-square and independent t-test, respectively. Multivariate logistic regression analysis determined the odds ratio and 95% confidence interval for incisional hernia predictors. All tests were two-sample. P-value < 0.05 was considered significant. The selection of variables in the model was made based on knowledge and clinical experience that produces a better model. We considered variables that are anticipated to cause an incisional hernia. Each variable was evaluated, controlling for the effect of possible and well-known confounders using ENTER method. Each variable was separately evaluated as we had a low incidence of incisional hernia (18 patients), not allowing to include many predictors in one model and may lead to a non-robust estimate. Additionally, to avoid multicollinearity, a very common, well-known problem in the case of multiple predictors. Multicollinearity can destroy a regression model and reverse the effect of predictors on the outcome.

Habeeb T.A., Hussain A., Shelat V., Chiaretti M., Bueno-Lledó J., García Fadrique A., Kalmoush A.E., Elnemr M., Safwat K., Raafat A., Wasefy T., Heggy I.A., Osman G., Abdelhady W.A., Mawla W.A., Fiad A.A., Elaidy M.M., Amr W., Abdelhamid M.I., Abdou A.M., Ibrahim A.I, & Baghdadi M.A. (2023). A prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro-muscular mesh: filling a step. World Journal of Emergency Surgery : WJES, 18, 15.

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Publication 2023

Incisional Hernia Patients

Incisional Hernia Risk after Colon Cancer Surgery

Data will be collected at the baseline (before surgery), during the hospital stay, at 30 days, and at 6, 12, and 36 months after surgery (Table 1). The primary outcome of this study is the incidence of incisional hernias, including both symptomatic and radiologic hernias, at 12 months after surgery. Incisional hernia is assessed by interviewing patients regarding subjective symptoms, performing a physical examination of the abdomen, and reviewing abdominal-pelvic computed tomography (CT) scans. An incisional hernia is defined as either a symptomatic hernia during the interview or a radiologic hernia when it is diagnosed on both an abdominal-pelvic CT scan and a physical examination in cases where subjective symptoms do not exist. The secondary outcomes are the length of hospital stay, estimated blood loss, pain numerical rating scale (0: no; 10: worst pain imaginable) score on postoperative days 1, 2, and 3; reoperation, open conversion, 30-day postoperative complications, (as classified by the Clavien–Dindo classification) [9 (link)], surgical site infection (as classified by the Center for Disease Control and Prevention criteria [10 (link)] and ASEPSIS score [11 (link)]), 30-day mortality, the incidence of repair of incisional hernias, pathologic result of colon cancer (pathologic stage, histologic type, differentiation, number of harvested and metastatic regional lymph nodes, lymphovascular, venous, and perineural invasion, and distant metastasis), and patient-reported outcomes (short form-12 health survey questionnaire before surgery, and at 12 months after surgery and Body Image Questionnaire at 12 months after surgery) [12 (link), 13 (link)]. The incidence of incisional hernia at 36 months after surgery is another secondary outcome that will be separately analysed and reported after the last patient enrolled completes the follow-up.Table 1

Schedule for assessment, interventions, and follow-up

Time point(visit number)	BaselineV0	OperationV1	1 monthV2	6 monthsV3	12 monthsV4	36 monthsV5
Assessment
Eligibility assessment
Consent	X
Demographics
Baseline data	X
Colonoscopy	*
Operative outcomes		X
30-day morbidity		X	X
30-day mortality		X	X
Symptomatic hernia			X	X	X	X
Radiologic hernia				X	X	X
Pathologic report			*
Adjuvant chemotherapy				*
Body image questionnaire					X
SF-12	X				X

Assessments undertaken as routine care for colon cancer are displayed with an asterisk

SF-12, short form-12 health survey questionnaire

Park S.Y., Ha G.W., Lee S.Y., Kim C.H, & Son G.M. (2023). Impact of non-muscle cutting periumbilical transverse incision on the risk of incisional hernia as compared to midline incision during laparoscopic colon cancer surgery: a study protocol for a multi-centre randomised controlled trial. Trials, 24, 152.

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Publication 2023

Abdomen Asepsis BAD protein, human Body Image Cancer of Colon Chemotherapy, Adjuvant Hemorrhage Hernia Herniorrhaphy Incisional Hernia Nodes, Lymph Operative Surgical Procedures Patients Pelvis Physical Examination Postoperative Complications Radionuclide Imaging Second Look Surgery Surgical Wound Infection Veins X-Ray Computed Tomography

Minimizing Incisional Hernia in Colon Cancer Laparoscopy

A small incision will be made by extending the periumbilical port for the camera scope in both groups. The size of the small incision will be determined based on the size of the tumour and the physical habits of the patient. The fascial closure methods are standardised as continuous closure using Stratafix (SF Symmetric PDS Plus®) with a 4:1 ratio (4-to-1 suture to wound length ratio) and bites of < 1 cm. The methods for closure of the subcutaneous fat and skin (skin stapler or 3–0 nylon vertical mattress) depend on the surgeon’s discretion. Patients randomly assigned to the midline group will undergo an incision along the midline skin, subcutaneous fat, and linea alba.
In the non-muscle-cutting periumbilical transverse group, the method of small incision is the same as in a previous report (Fig. 2) [6 (link)]. Briefly, the skin incision of the 11-mm periumbilical port will be extended transversely. Using monopolar electrocautery and crossing linea alba, the anterior and posterior rectus sheaths are transversely incised. With lateral traction of the rectus abdominis muscle with an army retractor, the posterior rectus sheath can be seen (Supplemental Video 1). The transversalis fascia and parietal peritoneum are further incised transversely. Continuous fascia closure will be separately performed for the anterior and posterior rectus sheaths. Implementing vertical or transverse incisions will not require alteration to usual care pathways (including the use of any medication), and these will continue for both trial arms.Fig. 2

A Transverse skin incision. B Transverse incision of the anterior fascia of the rectus abdominis muscle. C Transverse incision of the posterior fascia of the rectus abdominis muscle. D Incision completed. Note. This figure was produced by Chang Hyun Kim in 2022. From “Periumbilical Transverse Incision for Reducing Incisional Hernia in Laparoscopic Colon Cancer Surgery,” by Chang Hyun Kim et al., 2022, World Journal of Surgery,46(4): p918. Copyright 2022 by SPRINGER

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Publication 2023

Arm, Upper Bites Cancer of Colon Electrocoagulation Fascia Incisional Hernia Muscle Tissue Myotomy Neoplasms Nylons Operative Surgical Procedures Patients Peritoneum, Parietal Pharmaceutical Preparations Physical Examination Rectus Abdominis Skin Subcutaneous Fat Surgeons Surgical Procedures, Laparoscopic Sutures Traction Vision Wounds

Randomized Comparison of Incision Types

Data analysis will be performed using primary analysis (ITT), followed by secondary analysis (as-treated principles). The ITT set includes all patients who were randomised regardless of whether they received each incision, and the “per-protocol” analysis set includes patients who were treated according to protocol, excluding major protocol violations. Given our expectation, very few patients will crossover between incision types. All baseline and outcome data will be presented using frequencies with proportions for categorical variables and means with standard deviations for continuous data (or medians with interquartile ranges, whichever is more appropriate). The patients will be compared based on their baseline characteristics, including age, sex, body mass index, American Society of Anaesthesiologists classification, preoperative treatment (none, radiotherapy, or chemotherapy), comorbidities, medications, history of previous abdominal surgery, location of the tumour (right or left), and baseline short form-12 health survey questionnaire to determine the balance between the two groups. The primary outcome (the incidence of incisional hernia) will be analysed using the chi-square test. The secondary outcomes will be analysed using the chi-square test for categorical variables (i.e. type of surgery, resection, and anastomosis, incidence of 30-day postoperative complications, histologic type, and depth of the tumour), and Student’s t-test or Mann–Whitney U test for quantitative variables (i.e. operative time, length of hospital stay, blood loss, postoperative pain scores, size of the tumour, and the number of lymph nodes) as appropriate. In accordance with symptoms, each incision type will be evaluated during follow-up after surgery. However, it is not expected that there will be missing data relating to the primary outcomes. For other possible missing data, multiple imputations will be made, based on the assumption that the data are missing at random.
Subgroup analyses will be conducted for each randomisation stratum. The results will be evaluated at a significance threshold of p < 0.05 (two-sided). All of the statistical analyses will be performed using R statistical software, version 3.4.3 (R Foundation for Statistical Computing).

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Publication 2023

Abdomen Anesthesiologist Hemorrhage Incisional Hernia Index, Body Mass Neoplasms Neoplasms by Site Nodes, Lymph Operative Surgical Procedures Pain, Postoperative Patients Pharmaceutical Preparations Pharmacotherapy Postoperative Complications Radiotherapy Student Surgical Anastomoses

Comparing Incisional Hernia Rates in Surgical Incisions

This study aimed to test the superiority of the non-muscle-cutting periumbilical transverse incision over the midline incision, and the sample size was estimated based on the primary outcome (the incidence of incisional hernia at 12 months after surgery). Our previous retrospective study showed that the incidence of incisional hernias was 2.4% and 14.9% in non-muscle-cutting periumbilical transverse and midline incisions, respectively [6 (link)]. For this study, a conservative estimate rounded these incidences up to 2.5% and 15%, respectively. The sample size calculations were conducted in R using the pwr (pwr.2p.test); the required sample size for a superiority trial was determined to be 158 patients using power analysis (power = 85%, ɑ = 0.05, two-sided), and the dropout rate was anticipated at 10%. Finally, a total of 176 patients are required for randomisation.

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Publication 2023

Incisional Hernia Muscle Tissue Operative Surgical Procedures Patients

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What are the common causes of an incisional hernia?

What are the potential complications of an untreated incisional hernia?

How can PubCompare.ai help with incisional hernia research?

PubComapre.ai allows researchers to more efficiently screen protocol literature and leverage AI to pinpoint critical insights. The platform can help identify the most effective protocols related to incisional hernia repair, highlighting key differences in protocol effectiveness. This enables researchers to choose the best option for reproducibility and accuracy, streamlining their studies and making more informed decisions.

What are the different types of incisional hernia?

There are several variations of incisional hernias, including direct, indirect, and mixed types. Direct incisional hernias occur directly at the site of the surgical incision, while indirect hernias develop nearby but separate from the incision. Mixed hernias involve both direct and indirect components. Understanfing the specific type of incisional hernia is important for determining the most appropriate surgical approach and treatment plan.

How can PubCompare.ai enhance the reproducibility of incisional hernia studies?

PubCompare.ai's AI-driven analysis tools can help researchers identify the key differences in protocol effectiveness for incisional hernia repair. By highlighting the critical factors that contribute to successful outcomes, the platform enables researchers to choose the most reproducible protocols. This enhances the reliability and accuracy of their findings, ultimately improving patient care and reducing the risk of recurrence.

More about "Incisional Hernia"

Incisional hernias, also known as ventral hernias, are a common complication following abdominal surgery.
They occur when the surgical incision fails to heal properly, allowing internal organs or tissue to protrude through the weakened abdominal wall.
These types of hernias can develop after any type of abdominal procedure, including appendectomy, hysterectomy, or colon resection.
Incisional hernias can cause a range of symptoms, including pain, discomfort, and potentially serious complications if left untreated.
Effective management often requires surgical repair using techniques like open incisional hernia repair or laparoscopic incisional hernia repair to restore the integrity of the abdominal wall and prevent further complications.
Understanding the optimal surgical protocols for incisional hernia repair is crucial for improving patient outcomes and reducing the risk of recurrence.
Researchers can utilize AI-driven tools like those offered by PubCompare.ai to streamline their incisional hernia studies, locate the best protocols from literature, preprints, and patents, and enhance the reproducibility of their findings.
When it comes to the surgical repair of incisional hernias, various suturing materials and techniques may be employed, such as Polysorb, PDS Plus 2-0, or other absorbable or non-absorbable sutures.
Statistical software like SPSS, Statistica, SAS, or STATA can also be used to analyze data and optimize surgical outcomes.
By incorporating the latest research, innovative technologies, and proven surgical methods, healthcare providers can deliver more effective and personalized treatment for patients with incisional hernias, ultimately improving their quality of life and reducing the risk of recurrence.