Abdominal and ventral hernia surgery in Tijuana

What abdominal wall hernias are

This name covers every defect of the abdominal wall that is neither inguinal nor strictly umbilical. By far the commonest is the incisional hernia: the one that appears over the scar of a previous operation, weeks or years later, because that layer of tissue did not consolidate with its original strength.

There are also the epigastric hernia, in the midline above the navel; the Spigelian hernia, at the lateral border of the rectus muscle; and the lumbar hernia. And at the severe end, large ventral hernias with loss of domain, in which much of the abdominal contents live outside the cavity.

Why planning matters more here than in any other hernia

A large incisional hernia is not operated on like a small umbilical one. Before scheduling, the real size of the defect, the state of the musculature, how many previous repairs there have been and what material was used all need to be known. That calls for abdominal CT, not just examination.

The patient's own factors are prepared too, and honesty here saves reoperations: smoking, obesity and uncontrolled diabetes multiply the risk of recurrence and of mesh infection. In large hernias, postponing surgery a few months to correct those three points usually gives a better result than operating straight away.

Repair techniques

The principle is shared: reduce the contents, close the fascial defect and reinforce with a mesh extending several centimetres beyond the edges. What changes is the position of the mesh — preperitoneal, retromuscular, intraperitoneal — and the route of access, which may be open or laparoscopic.

In very large hernias or those with loss of domain, component separation techniques may be needed, releasing the muscle layers to allow the midline to close without excessive tension. These are major procedures, with a hospital stay of several days, and they are explained in detail before scheduling.

What the procedure involves

When it is indicated

• Incisional hernia over a previous abdominal surgical scar
• Epigastric midline hernia
• Spigelian and lumbar hernia
• Large ventral hernia with or without loss of domain
• Recurrence after one or several previous repairs
• Incarcerated abdominal wall hernia, as an emergency

Techniques and resources

• Polypropylene, composite and dual-sided meshes
• Component separation when required
• Laparoscopic tower for minimally invasive approaches
• Drains where the case demands
• Abdominal CT for pre-operative planning

Frequently asked questions about abdominal wall hernia surgery