Complex incisional hernia

Incisional hernias cause no or very few symptoms. You may notice a lump (bulge) in your abdomen where you've had previous surgery but they don't tend to cause too much pain or discomfort.

However, if you have a complex incisional hernia, you may experience a number of symptoms. They may occur multiple times, get quite large, be open or ulcerated, have an infected mesh (material used to repair hernias during surgery) or have fistulas (abnormal channels).

You may experience pain or discomfort and some people feel a burning or aching sensation where it pokes through particularly when straining, lifting or exercising.

Your GP or consultant will be able to identify if you have a complex incisional hernia by examining your lump and the affected area. It may be necessary to carry out an ultrasound scan to confirm the diagnosis. This is a simple, painless and non-invasive procedure that will help to assess how big your hernia is. The following factors may be taken into consideration before any treatment options are recommended:

• The risk of strangulation (when fatty tissue or parts of the bowel get caught in the hernia)
• If your symptoms are changing or the hernia is getting bigger
• The effect the hernia is having on your day-to-day life
• Your health in general

Your consultant will be able to advise you on the best treatment options for your condition. If your consultant recommends surgery. Surgery options include:

• Keyhole (laparoscopic) surgery
• Abdominal wall reconstruction

A special mesh which is strong and flexible is often used to strengthen the area and prevent the hernia returning. Alternatively, the muscle layers may be stitched together to make them stronger.