What Is an Ventral Incisional Hernia?

"Ventral" is an anatomical term that refers to the front of the body. When used specifically in reference to hernias, this describes an abnormal bulge of abdominal contents through the tissue of the abdomen, rather than through the tissue of other parts of the body. Incisional hernias are those bulges that occur due to weakened areas of tissue arising from surgical incisions, and therefore a ventral incisional hernia refers to a hernia through an old scar in the abdomen. Operations which may increase the risk of ventral incisional hernia are generally those which require entry through the abdomen.

Various muscles cross the abdomen and help to keep the contents of the abdomen inside the body. These include organs like the intestines, the stomach and the liver. When the muscles become weak or an old incision allows the abdominal contents through the muscular wall, then the outward bulge of the escaping organs is called a hernia. Most often, the cause of the bulge is part of the intestine.

Hernias can occur in the abdomen, in the groin, or in children, in the area of the umbilical cord. Abdominal hernias may be referred to as ventral or as incisional. Ventral simply refers to the front of the body, whereas incisional specifically relates to a bulge in the location of an old incision. Doctors may also combine the two descriptors to call a hernia an incisional ventral hernia, to specify that the bulge is both in the abdomen and is also due to a scar from a previous incision.

The muscles of the abdomen cross each other at angles to provide greater strength to the abdominal wall than it would have if the muscles ran parallel to each other. When these muscles are cut straight across, as happens in surgical incisions, this strength is reduced, and makes the resultant scar less robust than other areas of muscle. Any surgery which can produce an abdominal incision increases the risk of a ventral incisional hernia at the location of the scar, as the intestines can bulge through all the layers of the muscles at the same point.

One possible way of treating a ventral incisional hernia is to perform another operation that involves a further incision through the abdominal tissue. Alternatively, the surgeon can fix the hernia using laparoscopic techniques, which involve only tiny incisions and the insertion of a little camera into the area. Hernia patients may not even have to undergo a general anesthetic for the surgery.