49566 Repair recurrent incisional or ventral hernia; incarcerated or strangulated

Name of the Procedure:

Repair recurrent incisional or ventral hernia; incarcerated or strangulated.
Common Name(s): Hernia repair, Incisional hernia surgery, Ventral hernia surgery.

Summary

In this procedure, a surgeon repairs a hernia that has reoccurred at the site of a previous surgical incision or in the abdominal wall. The hernia is either incarcerated (stuck) or strangulated (cutting off blood supply). The surgeon will push the protruding tissue back into place and reinforce the weakened area.

Purpose

This procedure is performed to address hernias that have reappeared after a previous operation or have developed in the abdominal wall. It aims to relieve pain, fix the bulge, and prevent serious complications such as tissue death due to strangulation.

Indications

• Visible bulge in the abdomen or at the site of a previous incision.
• Pain and discomfort, especially when lifting, coughing, or bending.
• Symptoms of incarceration or strangulation such as severe pain, redness, vomiting, and inability to push the hernia back in.

Preparation

• Fasting for at least 8 hours before the procedure.
• Adjusting or stopping certain medications as advised by the doctor.
• Pre-operative tests including blood work, imaging studies like CT scans or ultrasounds.

Procedure Description

1. Anesthesia is administered, usually general anesthesia, to ensure the patient feels no pain.
2. The surgeon makes an incision near the hernia site.
3. The protruding tissue is carefully pushed back into the abdominal cavity.
4. The weakened area is reinforced using sutures and/or a surgical mesh to provide additional support.
5. The incision is then closed with sutures or staples.
6. A sterile dressing is applied to the incision site.

Duration

Typically takes 1-3 hours, depending on the complexity and size of the hernia.

Setting

Usually performed in a hospital or a specialized surgical center.

Personnel

• Surgeon
• Anesthesiologist
• Operating room nurses
• Surgical assistants

Risks and Complications

• Common: Infection, bleeding, pain at the surgical site.
• Rare: Recurrence of the hernia, damage to surrounding organs, mesh complications such as rejection or migration.

Benefits

• Relief from pain and discomfort.
• Correction of the visible bulge.
• Prevention of serious complications like strangulation and tissue death.
• Improved quality of life and physical function.

Recovery

• Initial recovery period usually lasts 1-2 weeks with pain managed by prescribed medications.
• Avoid heavy lifting and strenuous activities for at least 6 weeks.
• Follow-up appointments are necessary to monitor healing and progress.

Alternatives

• Watchful waiting for asymptomatic cases.
• Non-surgical treatments such as wearing a hernia belt (though this does not fix the hernia).
• Minimally invasive laparoscopic surgery as compared to open surgery, which may result in shorter recovery times and less scarring.

Patient Experience

• Patients may feel groggy and sore after waking up from anesthesia.
• Pain and discomfort in the days following surgery, manageable with pain medications.
• Gradual return to normal activities based on the surgeon’s recommendations.
• Follow-up care includes wound care and observation for any signs of complications.