Incisional hernia: symptoms and repair in Brisbane

An incisional hernia forms at a previous operation site

An incisional hernia develops when tissue pushes through a weakness in the abdominal wall where a surgical cut was made. Fat or bowel can bulge through the gap under the skin.

The change may appear months or years after surgery. Some people notice a small bulge that slowly grows. Others first notice discomfort near the scar during work or exercise.

The bulge can be more obvious when you stand, cough or tense your tummy muscles. It may cause a dragging feeling, skin irritation or difficulty bending. Tell your doctor if it is changing or limiting daily life.

A scar lump needs an examination to confirm the cause. If you are still trying to understand your symptoms, the hernia symptoms guide can help you prepare for that discussion. It cannot confirm a diagnosis.

A painful or changing lump may need urgent assessment

Seek urgent medical care if the bulge becomes hard, very painful or red, particularly if you also have nausea or vomiting. These changes can signal a trapped hernia or another complication.

Attend your nearest emergency department. For a medical emergency, call 000. Do not try to push a painful lump back in, and do not wait for an online booking request to be answered.

A comfortable lump that has been present for some time can usually be assessed through a planned appointment. Let your GP or the rooms know if symptoms change while you are waiting.

Examination and previous operation details help plan treatment

Dr Goutham examines your abdomen and asks about the operation that left the scar. The history helps explain what has already been done and what a further repair may involve.

Bring any previous operation reports and scans you have. Mention a past wound infection, an earlier hernia repair or mesh if these apply to you. It is also helpful to explain when the bulge appeared and which activities now cause trouble.

A CT scan is often used when planning an incisional hernia repair, especially for a large or recurrent hernia. It shows the size of the gap and the surrounding abdominal-wall muscles. Dr Goutham will explain whether it is needed in your case.

The plan takes account of your symptoms, the examination and your health. At the appointment, ask what the scan would help decide and whether more information from your previous operation is needed.

Repair timing depends on symptoms and the size of the hernia

An incisional hernia does not close on its own. It can enlarge over time, so an assessment is useful even when discomfort is mild.

A recommendation to repair it should include a discussion of timing. A small, comfortable hernia may allow time to prepare for surgery. A hernia that is growing or affecting daily life needs those changes taken into account.

Explain what matters to you. You may be struggling with physical work, feeling uncomfortable when bending, or concerned about a visible bulge. These details help make the consultation relevant to the problem you want treated.

Ask how the benefits of repair compare with its risks in your situation. You should understand why surgery is being suggested and what preparation is needed before making a decision. There is no pressure to schedule a planned operation at the first consultation.

Preparation addresses factors that can affect healing

Smoking, diabetes and problems with wound healing can matter when planning an incisional hernia repair. Dr Goutham reviews these with you so that preparation fits your health and the proposed operation.

If you smoke, discuss support to stop before surgery. If you have diabetes, ask whether your current control needs review. Nutrition and weight may also be discussed, particularly when a large repair is planned.

A long-term cough or constipation can add strain around a hernia. Mention these at the appointment so they can be considered. Some people need help with breathing or physical conditioning before a larger operation.

Bring a current list of medicines, including blood thinners. Your treating team will explain any changes needed before surgery. Never stop anticoagulants unless you have been given a clear plan by the clinicians managing them.

Preparation is individual. You will not necessarily need every measure described here, and the timing should be discussed alongside the symptoms from your hernia.

The repair is chosen for the gap and your previous surgery

The aim of incisional hernia repair is to return the bulging tissue and repair the weakness in the abdominal wall. Mesh is often used to reinforce the repair. Dr Goutham explains whether it is recommended and where it would sit.

Open or laparoscopic (keyhole) repair

An open repair gives access through an incision over the area. Laparoscopic (keyhole) surgery uses smaller cuts, a camera and instruments. The size and position of the hernia, previous surgery and your general health help determine which approach is suitable.

Robotic-assisted repair is another option for selected patients. It is keyhole surgery using instruments controlled by the surgeon through a robotic system. If it is being considered, ask why it suits your repair. The robotic hernia surgery article explains the approach in more detail.

Repairing a larger gap

A wider defect may need a more involved reconstruction. One technique, called component separation, releases layers of the abdominal wall so they can be brought together. This is discussed when needed, after the examination and scans.

You can ask Dr Goutham to show you the gap on your scan and explain the proposed repair in plain language. Ask about mesh at the same visit, including its purpose and the risks relevant to you.

Dr Goutham does not perform hiatal (paraoesophageal) or parastomal hernia repair — those are referred to upper-GI or colorectal sub-specialists.

The risks need to be discussed for your particular repair

Possible problems after incisional hernia repair include bleeding, infection and a collection of fluid near the wound. Discomfort can persist, and a hernia can return after repair.

A large reconstruction has different risks from a small repair. Ask which risks are most relevant to your previous surgery and health, and what can be done before the operation to reduce them.

If a hernia has returned after an earlier repair, that history needs a fresh assessment. Bring the earlier operation report if you can. The separate recurrent hernia page explains that situation.

For broader information about surgery, use the hernia surgery guide. The hernia surgery cost guide is the place to prepare questions about fees.

Recovery is longer after a larger reconstruction

A small incisional hernia may be treated as day surgery. A larger reconstruction can involve a hospital stay and a longer break from heavy work. Discuss this before setting a surgery date.

Tell Dr Goutham about your job and the physical tasks you need to manage at home. Ask how long you may need help and whether lighter duties are an option.

You receive advice about pain relief and wound care, with follow-up to review healing. The recovery after hernia surgery guide covers routine aftercare. Your own instructions take priority after a larger repair.

Book an assessment of a lump at your surgical scar

Book an incisional hernia consultation at Upper Edge Surgery in Brisbane and surrounds. If you need help arranging it, call the rooms on (07) 3333 5518.

Patients may book directly; a valid referral is needed for Medicare rebate processing. Send your referral and any available scans or operation reports before the visit.