Expert Treatment for Large Incisional Hernia Restore Your Health with Advanced Surgical Solutions
- Totally Laparoscopic Key Hole Repair
- Restoring Loss of Domain
- Expert Surgeon and Proven Results
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What is Large Incisional Hernia?
The Large Incisional Hernia cures at the site of a previous surgical scar where a significant amount of intestine comes out in to the Hernia cause in Loss of Domain
Symptoms of a Large Incisional Hernia
LOCAL
- Size: Enlarging hernia - Increased lateral muscle traction
- Tension: Decrease IAP - respiratory alterations
- Bowels: Thickened mesentery, altered venous/ lymphatic return, dilated bowels
- Skin and subcutaneous -Trophic ulcers (cutaneous hypoxia); secondary bacterial / fungal infection; fistula
SYSTEMIC
- Low backache: Musculoskeletal dysfunction
- Respiratory Failure: Discordant diaphragm, thoracic and abdominal muscle dysfunction; chronic respiratory failure
- Bowel dysfunction: Altered intestinal transit - inadequate muscle contraction / chronic gut obstruction in sac
- Micturationg dysfunction: Detrusor dysfunction - inability to raise IAP
- Personal issues: aesthetic; low self esteem
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Table of Contents
Loss of Domain in Large Incisional Hernias
Understanding and treating loss of domain—when a significant portion of abdominal contents is displaced outside the abdominal cavity into the hernial sac requires expert surgical intervention. Our team specializes in in treating this complex condition and restoring the domain
Botox Injection for Abdominal Wall Relaxation
Pre-surgical botulinum toxin (Botox) injections are used to relax the abdominal muscles, allowing for easier closure of the abdominal wall during hernia repair. This technique can reduce tension, improve surgical outcomes, and facilitate recovery in large hernias.
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Technique of Botox or BTA
A 5ml injection of Dysport® (50 units/5ml) or 3ml of Botox® (30 units/5ml) are administered at each point. Commercial brand Dysport, 50U of toxin are infiltrated in each of the 5 specific points on the right side and 5 on the left, for a total of 500U.
Measurement of LOD
- Preoperative CT volumetric analysis
ABBREVIATIONS
- IHV-Incisional hernia volume
- ACV – Abdominal cavity volume (excludes IHV)
- PV-total Peritoneal volume (IHV +ACV)
- IHV/PV
Measurement of LOD
- Tanaka index… IHV/ACV >0.25
- Sabbagh index IHV/PV >20%
Measuring LOD Radiologically
Treatment options available for Large Incisional Hernia
Laparoscopic Component Separation Technique
This advanced technique involves separating the different layers of the abdominal wall to create flexibility for tension-free hernia repair using a suitable sized mesh. This component separation could be either an anterior component separation or a posterior component separation. Laparoscopic component separation allows for larger defects to be closed with reduced complications and quicker recovery.
Abdominal Wall Reconstruction (AWR)
Abdominal Wall Reconstruction (AWR) is a specialized surgical technique used to repair and reconstruct the abdominal wall, particularly in cases of complex and large incisional hernias. This procedure is especially valuable for patients who have experienced multiple hernia recurrences, or those with significant defects in the abdominal wall following previous surgeries.
Key Aspects of Abdominal Wall Reconstruction:
Personalized Surgical Approach: Each patient’s condition is unique. The AWR procedure is tailored based on the size, location, and complexity of the hernia, as well as individual patient factors, such as previous surgeries, tissue quality, and general health.
Use of Advanced Mesh Techniques: Often, synthetic or biological mesh materials are incorporated to provide long-term support to the reconstructed abdominal wall. This helps reinforce weakened tissues and prevent hernia recurrence.
Comprehensive Abdominal Wall Restoration: The goal of AWR is not only to repair the hernia but also to restore the integrity, function, and appearance of the abdominal wall. This includes repositioning muscles, closing gaps, and ensuring that the abdominal structure is strong and resilient.
Multidisciplinary Care: AWR often requires a collaborative approach, involving specialists from general surgery, plastic surgery, and other relevant fields to achieve optimal outcomes.
Benefits of AWR for Large Incisional Hernias:
Reduced Recurrence Rate: By addressing the underlying weaknesses in the abdominal wall, AWR reduces the likelihood of future hernia recurrence.
Enhanced Abdominal Functionality: Patients may experience improvements in abdominal wall strength and core stability, positively impacting daily activities.
Improved Aesthetic Outcome: AWR often results in a more natural abdominal contour, especially beneficial for patients with large hernia bulges.
Management Multidisciplinary
- Recover anatomy/ functionality
- Prevent recurrence
- Adequate tissue cover
Pre op optimization
- Quit smoking
- Albumin > 3
- HbA1C < 7%
- Respiratory rehabilitation
- Weight Loss
- ACS - Ramirez vs Carbonell modification vs subcutaneous endoscopic (Daes)
- TRA/PCS
- Albanese triple incision
- Botox
- Tissue expanders
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FAQ
How is a large incisional hernia diagnosed?
A healthcare provider in Bangalore will diagnose a large incisional hernia through a physical examination. Imaging tests like ultrasound or CT scans may also be used to assess the size and condition of the hernia.
How can I prevent a large incisional hernia from recurring?
To help prevent recurrence, maintain a healthy weight, avoid heavy lifting, and follow your surgeon’s post-operative care instructions. Regular follow-ups and monitoring can also be beneficial.
Where can I find a specialized surgeon for large incisional hernia treatment in Bangalore?
Bangalore has several reputable hospitals and clinics specializing in hernia treatment. Research facilities, read patient reviews, and consult with experienced surgeons to find the right provider for your needs.