Is a vertical incision really required for a central midline incisional hernia?

I have a 4cm incisional hernia in my central midline area, about half way between my belly button and cesarean scar. The surgeon wants to do a vertical incision with mesh repair. I am reluctant for obvious reasons, particularly s I don't scar well, and want to know if it is required. I did have extensive adhesions with my 3rd cesarean 6 months ago (was told to avoid any further abdomibal surgery) but the vertical incision was discussed prior to their knowledge of this.

Doctor Answers 5

Hernia repair through abdominoplasty incision

Hi Belhall
From your description, it should be possible to repair that midline hernia through an abdominoplasty approach - a low horizontal scar around the height of your Caesarean scar. Most plastic surgeons are comfortable with repairing these types of hernias as part of our tummy tuck procedures - we see them frequently and just repair them as part of the procedure.
Good Luck
Dr Gavin Sandercoe

Is a vertical incision really required for a central midline incisional hernia?

It is probably not required if a tummy tuck flap can be raised safely. However, certain surgeons prefer to make a scar directly over a hernia to simplify the procedure.
Kenneth Hughes, MDLos Angeles, CA

Hernia repair with Tummy tuck

Hi there belhall and thanks for posting,
Whether you have a tummy tuck or not it should be possible to approach your hernia via a tummy tuck incision which would be better hidden as you suggest in your question.
The only circumstance to use a vertical scar, would be if you have a pre existing vertical scar AND you do not have enough laxity to remove the old vertical scar as part of a tummy tuck.
I would need to examine you and ask more about the reasons you have been told not have further abdominal surgery however that is an unusual recommendation.
Best wishes

Is a vertical incision really required for a central midline incisional hernia?

Assuming you are planning on tummy tuck surgery as well, the abdominal hernia can be addressed with the tummy tuck exposure. In other words, the lower transverse  decision will allow  exposure to the entire abdominal wall fashion and allow for repair of  abdominal wall hernias. Best wishes.

Vertical scar for incisional hernia repair?

Without examining you or at least looking at pictures it is impossible to say, however usually a vertical scar is not necessary to repair a hernia in the area you describe.  Generally a horizontal scar will give good access and also provides the option of removal of skin and fat - as in a tummy tuck.  It is quite common in tummy tuck patients to perform hernia repairs as part of their surgery.
The reasons your surgeon may have advised a vertical scar could be that they feel that you have inadequate laxity to allow a tummy tuck or that given you already have a vertical scar (assuming you do), then it is easier to utilise this scar rather than make a new one.
I suggest you discuss with your surgeon your concerns and wish you all the best with your surgery.
Kind regards,

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