Ventral is a word used by doctors to mean “the front”. Therefore, a ventral hernia is a defect in the front part of the abdominal wall. This defect or hole allows the protrusion of the internal organs of the abdominal cavity through the defect. Such internal organs may include abdominal fat or even a loop of bowel. When this protrusion is through a previous surgical scar over the abdominal wall, it is called an incisional hernia. For example, if a person has a previous operation to remove the appendix, or a previous Caesarian Section, and now has a hole along the scar – that is an incisional hernia.
It is often first noticed as a painless lump over the abdomen that is more apparent in an upright position and disappears on lying down. It is usually not painful; at most a mild ache may be felt. However, when the pain is severe, this may indicate a serious complication of the condition whereby the bowel loop that protrudes through the defect becomes deprived of blood supply. Equally ominous is distension of the abdomen accompanied by vomiting, as this may represent another complication of the condition whereby the bowel loop that protrudes through the defect becomes blocked.
It is advisable to seek medical attention whenever a ventral hernia/ incisional hernia is suspected or found. Though the person may not experience much discomfort, surgery is usually recommended to prevent the serious complications of the condition from happening.
The doctor is usually able to clinch the diagnosis with physical examination. The lump will typically protrude out on standing or on coughing. It will reduce on lying down. The surgeon will also try to measure the size of the defect – this will help him in his surgical planning.
Sometimes, especially if the person is obese, the defect or the lump may not be very apparent. In such cases, the doctor may order a scan to confirm the diagnosis and also to measure the size of the defect.
The definitive treatment for ventral/ incisional hernia is surgery. This can either be performed through an incision over the previous surgical scar, or directly over the hernia; or with keyhole surgery using much smaller incisions. The aim is to close the defect. This is usually achieved by placing a mesh to cover the defect.
In some cases, however, surgery may not be offered if the risk of recurrence is deemed to be high and outweighs the risk of complications arising from the hernia itself (for example when the patient is overweight and the hernia defect is wide).
This is caused by the weakening of the layers of muscle and tough fibrous tissues that form the abdominal wall. A surgical wound can never recover complete strength compared to before surgery. If the degree of weakening is severe enough, this may lead to the formation of an incisional hernia.
Whilst not completely preventable, constipation, straining when passing urine, carrying heavy weights or a chronic cough may aggravate the condition. In all these situations, there is an increase in the pressure within the abdomen, especially when the person strains. This increase in pressure will slowly enlarge the defect and worsen the condition.
For incisional hernia specifically, complications of the surgical wound, such as wound infection, will predispose to the subsequent development of an incisional hernia. Also, if the person’s nutrition is poor, the wound will heal poorly too.
Another thing to note, especially if a person has had a recent operation in the abdominal area, is not to carry heavy things for about 6 months, so as not to cause unnecessary strain on the wound. However, simple aerobic exercises like cycling, jogging and swimming are safe. Do consult your doctor for more details.
Colorectal & General Surgeon
Upper Gastrointestinal, Bariatric & General Surgeon
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Our clinics will be closed from 16 – 18 Feb for CNY
Our clinic at Mt Alvernia Medical Centre A will be relocating from #06-05 to #03-03 (within the same building) on Friday, 26 Sep afternoon.
Our telephone line 6353 4855 will be temporarily unavailable from 12:00pm – 6:00pm on 26 September. During this period, you may reach out to our other clinics for assistance:
We will begin operations at our new premises (#03-03) from Tuesday, 30 Sep onwards.
We look forward to serving you at our new clinic!
Nexus Surgical clinics at Mt Elizabeth Novena Specialist Centre, Gleneagles Medical Centre, Parkway East Medical Centre and Mt Alvernia Medical Centre will be closed on 28 January 2025 for Lunar New Year celebrations, while our clinic at Mt Elizabeth Orchard Medical Centre remains open from 0900-1300 hours on 28 January 2025.
Please leave a message in our voice mails and we will respond to you as soon as we can when we resume our clinics on 31 January 2025. If you require any urgent assistance, kindly go to the Urgent Care Centre of any hospitals or contact your doctor through the Emergency Answering Service. Our team at Nexus Surgical would like to take this opportunity to wish you and your loved ones a Happy & Prosperous Lunar New Year with good health in the Year of the Snake!
Nexus Surgical will be away from 17 to 20 October 2024 for our Annual Company Retreat. The aim of our retreat is to review and to recharge, so that we may serve you better.
Our clinics at Mount Elizabeth Orchard, Mount Elizabeth Novena, Mount Alvernia and Parkway East hospitals will therefore be closed during this period. In the meantime, if you require any urgent assistance, kindly contact us through our Answering Service at +65 6333 5550.
We thank you for your understanding and patience for any inconvenience.
