As defined by the American College of Surgeons, a ventral hernia is a bulge in an opening in the abdominal muscles. This condition has several different possible causes, but only one treatment option – surgical hernia repair.
After more than a decade of private practice as a General Surgeon in New Jersey, Vadim Gritsus, M.D. has successfully repaired thousands of hernias, of all types. When you come to our practice for ventral hernia repair, you can rely on Dr. Gritsus and his staff for advanced surgical solutions, surgical excellence, and individualized, compassionate patient care. This is why Dr. Gritsus is so well respected in his field, among some of the best hernia surgeons NJ can lay claim to.
What is a Ventral Hernia?
Ventral hernias arise in the abdominal wall, in the site of a previous abdominal surgery or where the abdominal muscles are weakened for any number of reasons. The inner lining of the abdomen pushes through the weakened abdominal wall to form a sac somewhat similar to a balloon.
Contents of the abdomen, such as fatty tissue or a loop of the intestines, can push into the sac, creating a hernia. When the contents of the abdomen become stuck in the sac, the hernia is “incarcerated” (trapped), and that can lead to a life-threatening condition – hernia strangulation – in which the blood supply is cut off to part of the intestines. Emergency surgery is required in cases of hernia strangulation.
When Does a Ventral Hernia Occur?
Ventral hernias can occur at any phase of life:
- At birth: Some infants are born with a ventral hernia because of congenital defects in the abdominal muscle wall.
- After surgery: A ventral hernia can develop at the site of a surgical incision, either shortly after or years after surgery is performed.
- Over time: Aging and various life factors can cause the abdominal muscles to weaken, creating a higher risk for ventral hernias.
Causes of Ventral Hernias
A ventral hernia can develop at any location along the abdominal wall.
This type of hernia can be caused by:
- Congenital defect: Incomplete closure of the abdominal wall while the fetus is developing can cause a ventral hernia birth defect.
- Incisional hernia: This is a ventral hernia that develops at the site of an incision made during abdominal surgery. Incisional hernias affect approximately 10% of all patients who undergo open abdominal surgery. It can develop shortly after the surgery or much later, after many years have passed.
- Aging: As we grow older, abdominal muscles begin to weaken, which increases the risk of a hernia.
- Heavy straining
Risk Factors for Ventral Hernias
People of all ages can develop a hernia, and particularly older people, with weakened abdominal muscles. Some infants are born with hernias because of congenital defects, when the abdominal wall does not develop properly in the womb.
Risk factors for ventral hernias include:
- Family history of hernia
- Lifting or pushing heavy objects
- Thin abdominal wall due to congenital defect
- Previous hernias
- Previous abdominal surgeries
Incisional Hernia Risk Factors
As reported by the American College of Surgeons, 5 out of every 1,000 patients who have laparoscopic abdominal surgery and up to 150 out of every 1,000 patients who have open abdominal surgery develop incisional hernias at the surgical site. Most of these hernias appear within 5 years after surgery.
Risk factors for incisional hernias include:
- Large abdominal surgical incisions
- Obesity (causes pressure and tension on the abdominal muscles)
- Post-operative infection
- Smoking (related to a higher post-operative infection rate)
- Weakness in the connective tissues
- Pulmonary disease
Ventral Hernia Symptoms
The first sign of a ventral hernia is usually a bulge under the skin. In some cases, it causes no discomfort. In other cases, there may be pain in the area with prolonged sitting or standing, lifting heavy objects, coughing, or straining during bowel movements or urination. The pain may be either a sharp or a dull ache that worsens toward the end of the day.
If you experience continuous or severe discomfort, nausea or vomiting, or redness in the area of the bulge, seek medical attention immediately. These symptoms may be an indication that the hernia has become incarcerated (stuck in the abdominal wall sac) or strangulated (cutting off blood supply to the intestines), which can be a life-threatening situation requiring emergency surgery.
Ventral Hernia Diagnosis
To diagnose a ventral hernia, your doctor will need to perform a physical exam, and may ask you to cough during the examination.
It is possible that your physician will also order diagnostic tests, which may include:
- Ultrasound of the area of the abdomen with the bulge
- CT scan (computerized tomography scan)
- MRI (magnetic resonance imaging)
Ventral Hernia Treatment
Hernia repair through surgery is the only treatment for a ventral hernia. If left untreated, a hernia can gradually grow larger, become entrapped, and develop into a serious health condition. According to the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), approximately 350,000 to 500,000 ventral hernia repairs are performed in the U.S. every year.
There are various surgical techniques to repair ventral hernias. Dr. Gritsus will select the best technique for your specific anatomy and symptoms. Factors to consider include the size and location of the hernia, previous hernias, general health, and age.Get Started
Ventral hernia surgical procedures include:
- Open hernia repair: This technique may be the best option for a very large hernia. The surgeon makes an incision near the site of the hernia, gently pushes the tissue back into place, and repairs the hernia with mesh, sutures, or a flap of tissue to close the muscle.
- Open mesh hernia repair: In this procedure, the physician surgically removes the hernia sac and places mesh over the hernia site. The surgeon attaches the mesh by suturing it to the stronger tissue around the hernia. The site is then closed with sutures, staples, or surgical glue. Open mesh repair is the best option in some cases for large hernia repairs. Mesh may reduce the risk of the hernia recurring.
- Laparoscopic hernia repair: There is less risk of infection or wound complications with laparoscopic hernia repair than with open hernia repair. In this procedure, the surgeon makes several small punctures or incisions in the abdomen. Hollow tubes known as ports or trocars are inserted in the incisions and surgical instruments are placed in the ports. Carbon dioxide gas is used to inflate the abdomen to give the surgeon a clear view of the surgical site. In laparoscopic hernia repair, Dr. Gritsus uses safe, lightweight, porous mesh that incorporates into the abdominal wall.
- Component separation technique: This method used in our New Jersey hernia repair utilizes a patient’s own tissues to cover the hernia. In this technique, some of the layers of abdominal wall are shifted around to provide coverage for the defect of the abdominal wall. During component separation, the function of the abdominal wall is restored and use of the mesh may not be necessary. Dr. Gritsus is proficient in the component separation repair of ventral hernias and can offer his advice whether you are a candidate for this surgery.
For hernias with no symptoms, or for patients of advanced age or in poor health, the recommended treatment approach for a ventral hernia may be to watch carefully and wait. With this approach, it is important to see a physician frequently and seek emergency medical attention if sudden sharp pain in the abdomen, nausea, or vomiting should occur. These symptoms may indicate an incarcerated or strangulated hernia.
There is no single type of surgery suitable for all ventral hernia patients and symptoms. Laparoscopic hernia repair is associated with lower infection rate and shorter recovery time. However, laparoscopic surgery may not be an option for patients with hernia incarceration or strangulation. Mesh has been shown to reduce the rate of hernias coming back after surgery. In some cases, hernia repair can be performed concurrently with gastric bypass surgery.
After careful examination and consultation, Dr. Gritsus can recommend the most appropriate surgical procedure in your particular case. He typically prefers a laparoscopic approach to ventral hernia repair for NJ patients whenever possible.
Obesity and Hernia Repair
If you are overweight, particularly in the abdominal area, it can reduce your chances for a successful hernia repair. It can also increase the risk of hernia recurrence, particularly with a large ventral hernia. Dr. Gritsus will use a computer algorithm to determine the risk of complications associated with your weight. If the risks are too high, he will offer to enroll you in a comprehensive, pre-surgery, weight loss program. Achieving a healthy weight can benefit your health overall, as well as reduce the risk of hernia surgery complications.
Benefits of Ventral Hernia Surgery
Surgery is the only method by which a ventral hernia can be repaired. Without surgery, over time, the hernia may grow larger, cause pain and discomfort, and present a risk of possible hernia incarceration and life-threatening hernia strangulation. Additionally, while laparoscopic surgery may be the best choice in terms of recovery and lower infection and wound complication risk, if surgery is delayed until the hernia becomes very large, incarcerated, or strangulated, laparoscopic hernia repair may no longer be an option.
After you recover from your hernia surgery in New Jersey, you can return to your normal life routine, with no further discomfort in most cases. Although there are risks associated with any surgery, when you recover from a successful ventral hernia surgery, you will no longer be facing the risks associated with not having the surgery.
Recovery Time with Ventral Hernia Surgery
How long it takes to recover from ventral hernia surgery will depend on the size of the hernia, the location of the hernia, the surgical technique used to repair it, and your age and fitness level. A large ventral hernia treated with open mesh repair surgery may require an overnight stay in the hospital and up to 6 weeks of recovery time. Laparoscopic ventral hernia repairs using mesh are typically performed as same-day surgery with approximately 2 weeks for full recovery. Dr. Gritsus will give you an estimate of the recovery time for your particular situation.
New Jersey Hernia Surgeon
Vadim Gritsus, M.D. is a New Jersey general surgeon specializing in hernia repair, bariatric surgery, and gallbladder surgery. He has successfully performed thousands of hernia repair procedures with a commitment to surgical excellence and compassionate patient care.
When you come to our office for treatment, you will find that Dr. Gritsus and his staff believe in a personalized, friendly, and compassionate approach. Our aim is to provide a gentle human touch along with technical expertise and advanced treatment options, for the best possible patient experience.
A ventral hernia should be treated sooner rather than later to prevent life-threatening complications, and before the hernia becomes too large for laparoscopic repair. If you have ventral hernia symptoms, call us today for an appointment with Dr. Gritsus. Our offices are conveniently located in Pequannock and Paramus and we accept most insurance plans.