A ventral hernia is a bulge created when tissues or organs push through a hole or weak spot in the abdominal muscles. It often happens at the incision site of a previous abdominal surgery.
Ventral hernias are common. They don’t always need immediate attention, though many will eventually need surgery to repair.
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What Is a Ventral Hernia?
A ventral hernia occurs when tissues or organs push through a hole or weak spot in the abdominal muscles, creating a bulge.
Most ventral hernias happen at the incision site of a previous abdominal surgery. Others can develop between the breastbone and belly button (epigastric) or around the belly button (umbilical).
Ventral hernias are common and don’t always need immediate attention. In fact, you may not realize you have a ventral hernia until your provider finds it during a physical exam or it causes you pain. Many ventral hernias are visible when you are straining your muscles but disappear when you lie down.
Ventral hernias won't go away without surgery. Many will eventually require surgery to repair.
According to the Food and Drug Administration, nearly 1 million hernia surgeries take place each year in the United States. About 350,000 of those surgeries are to repair a ventral hernia.
What are the types of ventral hernias?
There are three types of ventral hernias:
- Epigastric hernia — An epigastric hernia occurs in the abdomen between the breastbone and the navel, or belly button. They can be present at birth due to a gap in the abdominal muscles. They can also develop over time due to injury or repeated strain on the abdominal muscles.
- Incisional hernia — An incisional hernia occurs in the abdomen at the incision site of a previous surgery. The incision creates a weak spot, allowing tissues and organs to push through and create a bulge. It’s more common in people who had open surgery or those who got an infection after surgery.
- Umbilical hernia — Umbilical hernia occurs at or near the navel, or belly button. Most umbilical hernias are present at birth and go away on their own in a few years. Umbilical hernias in adults are rare and need surgery to repair.
How common are ventral hernias?
Ventral hernias are very common. Surgeons in the United States perform about 350,000 ventral hernia repairs each year. More than 20% of people will develop a ventral hernia at some point in their lives.
What causes a ventral hernia?
Some ventral hernias are present at birth, including many epigastric hernias and most umbilical hernias. Other hernias develop over time, typically due to a weak spot in the abdominal muscles. Injury, previous abdominal surgeries, or repeated strain on the abdominal muscles can cause these weak spots.
Common conditions and activities that make developing a ventral hernia more likely include:
- Abdominal injury.
- Abdominal surgery.
- Childbirth.
- Chronic constipation.
- Chronic cough.
- Congenital defect, or birth defect.
- Connective tissue disorder.
- Lifting or push heavy objects.
- Obesity.
Ventral hernia risk factors
Anyone can develop a ventral hernia, but they are more likely if you are:
- Diagnosed with a connective tissue disorder.
- Doing activities that put pressure on the abdominal muscles, such as heavy lifting.
- Obese.
- An older adult.
- A smoker with a chronic cough.
Ventral hernia complications
Ventral hernias are often small and cause little discomfort. In fact, you may not realize you have a ventral hernia until:
- It starts causing you pain.
- Your provider finds it during a physical exam.
- Your provider sees it on an imaging study.
If the hernia becomes symptomatic or impacts your daily activities, your provider will likely recommend surgery to repair it.
The most common hernia complication happens when the hernia gets stuck and strangulated. This cuts off the blood supply and can result in dead tissue or a blocked intestine. This is an emergency.
You should see a doctor immediately if you experience the following symptoms:
- A hernia that cannot be pushed back into the abdominal wall.
- A hernia that suddenly grows.
- Nausea or vomiting.
- Redness around the hernia.
- Severe pain in your in your abdomen.
How can I prevent ventral hernia?
You can’t prevent a ventral hernia, particularly those present at birth. But you can reduce your risk by avoiding activities that put intense pressure on your abdominal muscles.
Some measures your doctor may recommend:
- Lift heavy objects with proper form to prevent twisting or straining.
- Maintain a healthy weight.
- Strengthen your abdominal, or core, muscles.
- Stop smoking to reduce your chances of chronic cough.
What Are the Signs and Symptoms of Ventral Hernia?
Many people don’t realize they have a ventral hernia until their provider discovers it during a physical exam.
Or you may notice:
- A lump or bulge in the belly area that is visible when straining your muscles.
- Pressure or pain in the abdomen area.
When should I see a doctor about my ventral hernia symptoms?
If you notice a lump on your belly, you should make an appointment with your medical provider. If a ventral hernia is causing the lump, your provider may tell you to monitor the lump or may recommend surgery.
Sometimes, a ventral hernia can get stuck or strangulated, which cuts off blood supply. It requires emergency surgery.
See a doctor right away if you have any of the following symptoms:
- A hernia that cannot be pushed back into the abdominal wall.
- A hernia that suddenly grows.
- Nausea or vomiting.
- Redness around the hernia.
- Severe pain in your lower abdomen, groin, or upper thigh.
How Do You Diagnose Ventral Hernia?
Providers can often diagnose a ventral hernia during a routine physical exam. However, ventral hernias can “hide” or be mistaken for other conditions. Because of that, your provider may order imaging tests to make the correct diagnosis.
Tests to diagnose ventral hernia
- CT scan — A CT scan used a series of x-rays to create a three-dimensional image of the tissues and organs in your abdomen. It is painless and noninvasive.
- MRI — An MRI uses a powerful magnetic field to create a detailed image of your tissues and organs. It is painless and noninvasive.
- Ultrasound — An ultrasound uses sound waves to create an image of your tissues and organs. It is painless and noninvasive.
How Do You Treat Ventral Hernia?
Lifestyle changes
Lifestyle changes cannot fix or prevent a ventral hernia. But they can reduce your risk of developing one.
Here are some things you can try:
- Lift heavy objects with proper form to prevent twisting or straining.
- Maintain a healthy weight.
- Strengthen your abdominal, or core, muscles.
- Stop smoking.
Nonsurgical treatment for ventral hernia
Because many ventral hernias start out small and cause little discomfort, doctors often recommend “watchful waiting.” This is when you and your doctor track the hernia and act when necessary. If the hernia gets too large or becomes painful, your doctor will likely recommend surgery.
Surgery for ventral hernia
Surgery is the only way to repair a hernia. Surgery for a ventral hernia is called ventral herniorrhaphy.
Typically, your surgeon will use one of two surgical methods to repair your hernia:
- Minimally invasive (laparoscopic or robotic) surgery — Your doctor will make several small incisions in your abdomen and use tiny instruments and a camera to repair your hernia. Minimally invasive surgery usually means less pain and faster healing time.
- Open surgery — Large or more complicated hernias may need open surgery. In this type of surgery, doctors make one long incision in your abdomen to repair the hernia. They close the incision with stitches or surgical mesh. Doctors often use surgical mesh for hernias to help strengthen the weak spot created by the original surgery.
What happens during surgery for ventral hernia?
Most hernia surgeries take place in a hospital under general anesthesia or with local anesthesia and sedation. You may need to stop eating, drinking, and taking certain medications in the hours before your surgery.
Smoking increases your risk of infection after hernia surgery. Your doctor may recommend quitting in the weeks before surgery.
During surgery, your doctor will:
- Push the bulging tissue or organ back into place.
- Repair the weak spot in your abdominal wall.
- Use surgical mesh to strengthen the abdominal wall and prevent another hernia. Mesh is used in most elective hernia repairs.
You should call your doctor right away if you experience any of these symptoms after your hernia surgery:
- Abdominal pain and swelling.
- Continuous vomiting.
- Fever.
- Foul-smelling or pus-like drainage from your incision.
- No bowel movements after two to three days.
- Pain that gets worse and cannot be controlled with medication.
- Swelling, redness, or bleeding near the incision site.
Is surgery the right treatment for my ventral hernia?
Not all ventral hernias need immediate attention, but surgery is the only way to repair a ventral hernia.
People who smoke, have diabetes, or are overweight have an increased risk of complications after hernia surgery. If you have these health concerns, speak with your provider about whether hernia surgery is right for you.
How long does it take to recover after surgery for ventral hernia?
Depending on your overall health, the size of your hernia, and the type of surgery you received, you may be able to resume some activities in the days after your surgery. Light activity can help to prevent blood clots and pneumonia.
Full recovery takes several weeks. Your doctor will give you specific post-operation instructions.
How successful is surgery for a ventral hernia?
Ventral hernia surgery is usually successful. However, there is a chance of recurrence, or your hernia returning. The likelihood of this happening depends on the type of surgery you have and whether your doctor uses mesh.
Laparoscopic surgeries with mesh have a 10% to 12% recurrence rate. Open surgeries with mesh have a 13% to 15% recurrence rate. Open surgeries without mesh have an 18% to 20% recurrence rate.
Why Choose UPMC for Hernia Surgery?
At UPMC, we provide comprehensive care for ventral hernias. You can expect:
- Access to new and innovative treatment — Nearly all our surgeons take part in clinical or laboratory research. Their discoveries ensure that patients receive the latest treatments using the most advanced techniques.
- Expert care — Our team works together to diagnose and treat patients with the most advanced care available. All of our surgeons are certified by the American Board of Surgery. Many are nationally renowned for the comprehensive care they provide patients.
- Locations close to home — We care for patients at locations in Pennsylvania, New York, and Maryland. That means you never have to travel far to receive the world-class care you need.
