Section 2 Ventral Hernia

**9**

**Chapter 2**

**Abstract**

Management

*Abdul Mannan Khan Rao*

of patient and wound is also discussed.

open technique, laparoscopic technique

**1. Introduction**

surgical problem.

**Keywords:** hernia, ventral, incisional, anterior abdominal wall defect,

In general term, the ventral hernia is the protrusion of intra-abdominal contents, through the anterior abdominal wall fascia defect [1], except groin hernia. In this way ventral hernia may be umbilical, paraumbilical, epigastric, incisional, Spigelian, parastomal, and lumbar. Sometimes this term creates confusion, because in Europe the term "ventral hernia" is used for incisional hernia, while in USA, this term is used for abdominal wall hernia, other than groin hernias [2]. In this chapter we will focus more on incisional hernias because worldwide this is a more common

Primary abdominal hernia can occur spontaneously at any area of natural weakness of abdominal fascia and muscles. Unlike abdominal wall hernias, which occur through a weak anatomical point, incisional hernias occur through a weakness at the site of abdominal wall closure after surgery. Ventral (incision) hernia is a common complication after open abdominal surgeries with an incidence of approximately 10% [3]. The true incidence is difficult to determine; the reasons for this are the lack of standardized definition, the inconsistency of data sources, and

Ventral Hernia: Causes and

Ventral hernia is the most common type of hernia after inguinal hernias. The term "ventral hernia" creates some confusion, because in most countries of the world, especially in Europe, it is considered as incisional hernia, while in the USA, it is usually considered as hernias of anterior abdominal wall except groin hernias. Daily in the world millions of abdominal surgeries are being performed by both open or conventional and laparoscopic techniques, with 3–20% incidence of incisional. That's why mainly incisional hernia and its causes, risk factors, and predisposing conditions and management will be discussed in this chapter, though other ventral hernias will be described briefly. The important causes, risk factors [congenital and acquired (patients and postoperative)], and predisposing conditions for ventral hernias will be discussed in detail. The signs and symptoms produced by ventral hernia (incision) will be described initially and later, and how to investigate to confirm the diagnosis and necessary investigations before surgery for different types of patients is described. In managing the ventral hernia, different treatment options are discussed and described, like conservative management, open method, laparoscopic technique, and more advanced robotic technique. After surgery postoperative care

#### **Chapter 2**
