Incisional Hernia Repair
If you’ve had abdominal surgery in the past and you’re now noticing a bulge, pressure, or pain near the scar, an incisional hernia may be the reason. Incisional hernias are one of the most common complications of abdominal surgery, particularly after larger open procedures. The good news is early evaluation can help your surgeon determine the best treatment approach before the hernia becomes more difficult to repair.
At Specialty Surgical Associates, our board-certified surgeons offer incisional hernia repair using open, laparoscopic, and robotic-assisted approaches. The right approach for you depends on the specifics of your hernia and your medical history.
Schedule Your Incisional Hernia Consultation
If you notice a bulge or discomfort near a previous surgical scar, call our office today or request an appointment online to discuss your treatment options.
What Is an Incisional Hernia?
An incisional hernia is a bulge that forms at or near an old surgical scar. It happens when the abdominal wall doesn’t fully heal after an operation, leaving a weak spot where tissue can push through over time. Some incisional hernias appear within weeks of surgery; others show up months or even years later.
To picture what’s happening: every abdominal surgery involves closing the muscle and connective tissue of the abdominal wall in layers. When those layers heal well, they hold up against everyday pressure like lifting, coughing and straining. When healing is incomplete because of infection, tension on the closure, or other factors, the incision may remain weaker than the surrounding tissue. That weak spot is what eventually gives way.
A few factors can prevent a surgical incision from healing as strongly as the surrounding tissue:
- Emergency surgery, where conditions for a clean closure aren’t always ideal
- Larger, midline incisions, which carry more tension than smaller ones
- An infection at the original incision
- Obesity
- Diabetes, smoking, or a compromised immune system at the time of the original surgery
- A prior incisional hernia repair, since the same site can weaken again
These risk factors are well-established and help explain why one patient develops an incisional hernia and another doesn’t. Left alone, incisional hernias tend to grow. Smaller hernias are generally easier to repair, with faster recovery and a lower chance of coming back, which is why we recommend getting them evaluated early.
Incisional Hernia Symptoms
The classic sign is a visible bulge at or near an old surgical scar. It’s often more noticeable when you’re standing up, coughing, or straining, and it may seem to shrink or disappear when you lie down. Many patients also describe a pulling or dragging feeling in the area, pressure at the incision, or discomfort that gets worse with activity, lifting, or bowel movements.
Some incisional hernias are painless early on and only become uncomfortable as they grow. A few warning signs mean you should be seen right away: a bulge that suddenly becomes hard, painful, or discolored; nausea and vomiting; or the inability to pass gas or stool. These can be signs of incarceration (tissue getting stuck in the hernia) or strangulation (blood supply being cut off). Both are surgical emergencies. Short of that, any new bulge, growing bulge, or pain near a past incision is worth an evaluation.
How Is An Incisional Hernia Diagnosed?
An incisional hernia can often be diagnosed during a physical examination. Your surgeon will look specifically at the area of the previous incision and may ask you to stand, cough, or strain so the bulge is easier to see and feel. If the diagnosis is unclear, or if the hernia is large, recurrent, or complex, imaging such as a CT scan may be recommended to show the size and location of the defect and any tissue or intestine involved.
Incisional Hernia Treatment Options
Every incisional hernia is a little different, and the right repair depends on the size and location of the hernia, your general health, and what your previous surgery looked like. Small, straightforward hernias can often be repaired laparoscopically or robotically as outpatient procedures. Mesh is used in most repairs to reinforce the abdominal wall: studies have consistently shown that mesh repair significantly reduces the chance of the hernia coming back compared with stitching alone.
- Laparoscopic Repair — a minimally invasive approach through a few small incisions. Often a good fit for smaller, first-time hernias with healthy surrounding tissue. Faster recovery, less scarring, and less post-operative pain than open surgery.
- Robotic-Assisted Repair — offers enhanced precision and visibility, particularly useful when the hernia sits near old scar tissue or needs careful dissection. It can also provide greater flexibility for carefully closing and reinforcing the abdominal wall.
- Open Repair — used when direct access to the abdominal wall gives the best outcome — for instance, when significant reconstruction is needed for larger hernias.
- Mesh Reinforcement — used in most repairs to reinforce the weakened area around the previous surgical incision and reduce the risk of recurrence. Modern mesh materials and placement have made repairs significantly more durable than they were a generation ago.
For larger, recurrent, or complex incisional hernias — including cases involving prior mesh complications, infection, or significant abdominal wall weakness at a previous incision site — advanced techniques such as component separation may be required. See our complex abdominal wall reconstruction page for more on those cases.
How to Prepare for Incisional Hernia Surgery
Before surgery, your surgeon will typically review your prior surgical history and order imaging, usually a CT scan, to get a clear picture of the hernia and any existing mesh. You may also receive preoperative guidance on things like smoking cessation, weight management, or blood sugar control where those apply. These factors can meaningfully affect how well you heal and how likely the hernia is to come back.
Most minimally invasive incisional hernia repairs are done on an outpatient basis or with just a short hospital stay. Expect some soreness at the repair site for the first several days, with a gradual return to normal activities over the following weeks. Heavy lifting should be avoided until your surgeon clears you: the exact timeline depends on the size of the hernia and the approach used.
Call your surgeon’s office right away if you develop a fever, notice signs of infection, have severe or worsening abdominal pain, or see redness, swelling, or drainage from the incision. Follow-up visits are how we check on your healing and catch any concerns early.
Benefits & Risks of Incisional Hernia Repair
A successful incisional hernia repair relieves the pain and bulging, restores strength to the abdominal wall, and prevents the more serious complications that can develop if a hernia is left untreated, especially incarceration and strangulation.
Every surgery carries some risk. For incisional hernia repair, that includes infection or bleeding at the site, the possibility of the hernia coming back, chronic discomfort at the repair site, rare mesh-related complications, and the general risks that come with anesthesia. Your surgeon will walk through all of this with you before the procedure and tailor the approach to your situation.
Why Choose Specialty Surgical Associates
Patients across New Jersey choose our practice for incisional hernia repair because of our depth of experience with abdominal wall surgery. Our board-certified surgeons have extensive experience in hernia repair and use minimally invasive and robotic-assisted techniques when appropriate. We tailor each surgical plan to the individual patient. The same procedure isn’t right for every hernia, and matching the right repair to the right patient is what produces durable outcomes.
Frequently Asked Questions
How common are incisional hernias?
More common than most people realize. Incisional hernias are one of the most common complications of open abdominal surgery, with higher rates after larger midline or emergency operations. Your risk is meaningfully higher if you have obesity, diabetes, a smoking history, or had a wound infection after your original surgery.
How soon after surgery can an incisional hernia develop?
The highest-risk window is in the months following surgery, but incisional hernias can appear weeks after surgery or many years later. Any new bulge near an old surgical scar is worth getting checked no matter how long ago the original surgery was.
Can an incisional hernia go away on its own?
No. Incisional hernias don’t heal on their own. The defect created at the previous surgical site needs a surgical repair. Left untreated, they tend to get bigger over time, and a bigger hernia usually means a more involved surgery down the line. In some cases, waiting too long can lead to an emergency.
Is mesh always required?
For most incisional hernias, mesh is used because it reinforces the weak area of the abdominal wall and significantly reduces the chance of the hernia coming back compared to stitching alone. Very small hernias in otherwise healthy tissue may occasionally be repaired without mesh, but that’s a conversation you’ll have with your surgeon based on your specific case.
Can an incisional hernia come back after repair?
It can. Even with modern mesh-based repairs, recurrence remains a possibility, and the risk is higher for larger hernias, repeat repairs, and patients with ongoing risk factors like obesity or smoking. If you’ve had a hernia come back after a previous repair, you may be a candidate for specialized reconstruction. Learn more about that on our complex abdominal wall reconstruction page.
What’s the difference between an incisional hernia and a ventral hernia?
“Ventral hernia” is the broader category: any hernia in the front wall of the abdomen, including ones that develop on their own (like umbilical or epigastric hernias) and ones that develop at surgical scars. An “incisional hernia” is a specific kind of ventral hernia: one that shows up at the site of a past surgery. Every incisional hernia is a ventral hernia, but not every ventral hernia is incisional.
How long is recovery?
It depends on the hernia and the type of repair. Recovery after a minimally invasive laparoscopic or robotic repair is usually meaningfully faster than after an open repair, but your surgeon will give you a specific timeline based on your case.
What happens if I delay surgery?
Incisional hernias tend to grow over time as more tissue pushes through the weak spot. Delaying repair usually means a bigger hernia, a more complex surgery, and a longer recovery when you do get it fixed. In some cases, a hernia can become incarcerated or strangulated. Both are surgical emergencies that need immediate treatment.
Schedule Your Incisional Hernia Evaluation
You don’t need to wait until an incisional hernia is causing serious problems to get it looked at. Our board-certified surgeons at Specialty Surgical Associates offer expert evaluation and the full range of repair options, right here in New Jersey. Call our office or request a consultation online to get started.