What is a Ventral Hernia?
When a separation or hole is present in the abdominal wall, it can allow abdominal tissue, such as part of an intestine, to push out through this hole forming a hernia. If the hernia is positioned in the vertical center of the abdominal wall it is classified as a ventral hernia. Ventral hernias are broken down into three categories which include:
Epigastric Hernia – Found in both adults and children, epigastric hernias are usually located in the area between the sternum and the belly button and makeup about 3% of all abdominal hernias.
Umbilical Hernia – These hernias form around the belly button and are common in infants but can also occur in adults.
Incisional Hernia – Appears around the scar or incision site of a former abdominal surgical procedure. Incisional hernias can form months or even years after surgery and makeup about 20% of abdominal hernias.
What causes a Ventral Hernia?
Incision site weakness (possibly caused by infection or failed mesh surgical repair);
At birth, there was a weakness in an area of the abdominal wall;
Conditions that cause exertion or straining of the abdominal wall can create weaknesses and hernias. Straining can be caused by conditions such as:
- Bowel injuries.
- Chronic coughing.
- Excessive or acute vomiting.
- Pushing or lifting heavy objects.
- Weakness of abdominal wall due to aging.
- Constipation causes straining to have a bowel movement.
- The prostate enlargement causes men to strain to urinate.
- Lung diseases cause individuals to struggle to breathe and put a strain on the abdominal wall.
What are the Symptoms of a Ventral Hernia?
A ventral hernia may cause no symptoms at all or may create a bulge in the abdominal wall. This bulge may expand when coughing or exerting pressure such as while lifting a heavy object. The bulge may not create any discomfort or can be tender and painful.
Symptoms that are commonly associated with a ventral hernia include:
- A painful lump in the abdomen.
- The skin over the abdominal bulge is red.
- A lump or area that bulges on the abdomen but is not painful.
- A lump in the abdomen that can be temporarily reduced by pushing with gentle pressure.
- An abdominal bulge that gets bigger when pressure is increased such as while coughing or lifting a heavy object.
Uncommon, but serious ventral hernia symptoms include: In rare instances, ventral hernia symptoms can be life-threatening and require immediate medical attention.
Some of the symptoms to watch for include:
- Chronic nausea or vomiting.
- Sharp or severe pain in the abdomen.
- Tight skin that is red and stretched over a swelling bulging area.
- Difficulty having bowel movements or passing gas.
- Fever of over 101 degrees.
- Low output or no output of urine (infant who is not producing wet diapers with normal frequency).
What are the Symptoms of a Ventral Hernia?
Adults or children who have a weakness in their abdominal wall causing internal organs or tissue to protrude outside of the abdominal cavity may be candidates for ventral hernia repair. Hernia repair may be performed if:
What Treatments are available?
As a rule, ventral hernias do not go away on their own and eventually require surgical intervention to mitigate the risks of intestinal strangulation. A ventral hernia repair with mesh is the most commonly used treatment.
The exception to this rule is when a ventral hernia is present in an infant (umbilical hernia) they normally go away by the time the child reaches the age of 4 or 5. If the hernia is still present after that time, then surgery may be necessary.
Ventral Hernia Surgery Procedures
Ventral hernia repairs can be performed through one of three techniques. Open ventral hernia repair, laparoscopic hernia repair, or robotic-assisted laparoscopic hernia repair.
1. Laparoscopic Hernia Repair
Laparoscopic ventral hernia repair is considered a minimally invasive procedure and is normally done while the patient is asleep under general anesthesia.
The ventral hernia repair is performed through about 3 to 5 small incisions made in the abdomen. A hollow tube-shaped surgical tool with an attached camera called a laparoscope guides the surgeon during the procedure.
The surgeon will push the bulging tissue back into place and close and repair the weakness in the abdominal wall using a special surgical mesh. This material will help support and strengthen the abdominal weakness in this area and help prevent future occurrences.
Some benefits of laparoscopic ventral hernia repair include:
- Fewer complications.
- Shorter recovery times.
- Reduces the risks of post-operative infection.
2. Robotic-Assisted Laparoscopic Hernia Repair
During a robotic ventral hernia repair, the same procedure steps and tools are used as during laparoscopic ventral hernia repair. The only difference is that instead of the surgeon manually holding the surgical tools, robotic arms are holding the tools while the surgeon controls them using a computer console with a viewing screen.
3. Open Hernia Repair
Open ventral hernia repair can be done using general anesthesia or using local anesthesia and is often a good choice for patients who are intolerant to general anesthesia.
During open ventral hernia repair, the surgeon creates an incision in the abdomen targeting the location of the hernia. The protruding abdominal or intestinal tissue is pushed back through the opening and normally a mesh material is used to repair and reinforce the area to avoid a future recurrence. The incision is normally closed with dissolvable sutures and surgical glue.
How long is Recovery Time from Ventral Hernia Surgery?
The recovery time from ventral hernia repair will vary from patient to patient and be dependent on the size, location, and extent of the repair and the technique performed. Many ventral hernias can be repaired in an outpatient setting while some large ventral hernias or more complicated hernias may require a hospital stay.
The surgeon will provide aftercare instructions to each patient specifically tailored for them which may include instructions about when they may return to work, shower, drive, resume normal activities, etc. Some patients may be required to wear a special compression garment for 4 to 6 weeks that will provide stability and help prevent excessive swelling while the hernia repair site heals.
The typical recovery from laparoscopic ventral hernia surgery is between two to six weeks.
Deciphering information about your Hernia Repair from your Medical Records
What does it mean when you see laparoscopic ventral hernia repair CPT 49652 in your medical records?
With all the HIPPA laws and advancements in technology, more and more of our medical records are being loaded into an online program for us to access. After we attend an appointment, have lab tests, or undergo a procedure, we receive notification that the results have been posted to “our chart”.
In the results, you will probably find numbers called CPT codes, or “current procedural terminology” codes. These codes are maintained by the American Medical Association and are universally recognized for the condition, illness, or treatment they are describing in the chart. So if you see CPT 49652 in your medical chart, this is the universally recognized procedural code for a laparoscopic ventral hernia repair.
Where can I get a Laparoscopic Ventral Hernia Repair in Atlanta?
If you are concerned about a hernia that has formed in your abdomen, contact IBI Healthcare Institute and set up a free consultation.
Dr. Chris Ibikunle, MD, FACS, and the professionals at IBI Healthcare Institute perform laparoscopic ventral hernia repairs in Atlanta at their state-of-the-art surgery center serving Buckhead, Loganville, Duluth, and the surrounding areas.
How much does Hernia Repair cost?
The cost of Ventral Hernia Repair surgery will vary by patient taking into consideration different factors such as the size of the hernia, the type of hernia repair performed, the type of mesh used if any, and other patient-specific factors.
The average cost of ventral hernia repair in the United States ranges between $4,000 and $11,000.
Ventral hernia surgery is usually covered by health insurance as it is not considered cosmetic. The financial responsibility of the patient may be offset through the use of insurance, FSA, or HSA programs.
Schedule a consultation or contact us to inquire most about Laparoscopic or Open Ventral Hernia Repair procedure costs and flexible financing options.